| Objective To investigate the effect of aseptic biofilm for improving the treatment of severe traumatic wound.Methods From January 2019 to December 2020,42 eligible patients with severe traumatic wound were admitted to the Department of Burn and Plastic Surgery of the First Affiliated Hospital of Soochow University in this study.they were divided into aseptic biofilm group and control group.In aseptic biofilm group,the wounds were covered with aseptic biofilm combined with negative pressure drainage therapy after debridement in the first stage,and autologous split-thickness skin graft or flap transplantation was performed according to the injury in the second stage.There were 21 patients in aseptic biofilm group,including 13 males and 8 females.The youngest was 24 years old,the oldest was 77 years old,and the average age of the youngest was(51.14± 16.04)years old.The causes of injury were traffic accidents in 12 cases(28.57%).Bruised by heavy object in 4 cases;2 cases of falling injury;Machine crush injury occurred in 3 cases.The control group was treated with mesh gauze covering combined with negative pressure drainage therapy after debridement in the first stage.Autologous split-thickness skin graft or flap transplantation was operated according to the injury in the second stage.There were 21 cases in the control group,including 14 males and 7 females.The youngest was 24 years old and the oldest was 76 years old,with an average age of(49.67± 15.48)years old.Bruised by heavy object in 4 cases;2 cases of falling injury;Machine crush injury occurred in 3 cases.The time of wound substrate preparation,the results of wound bacterial culture,the VAS score of wound pain during dressing change,the survival of autologous skin graft and flap transplantation,the wound healing time,the length of hospital stay,the occurrence of adverse events of treatment,and the follow-up of Vancouver Scar Scale score were observed in the two groups.SPSS20.0 statistical software was used for statistical analysis.Results ①Time of wound substrate preparation:the shortest time of wound substrate preparation of patients in aseptic biofilm group was 7 days and the longest was 14 days,with an average of(8.90±2.73)days.The shortest time of wound substrate preparation of patients in control group was 7 days and the longest was 18 days,with an average of(11.62±3.78)days.The wound basal preparation time of the aseptic biofilm group was lower than that of the control group.and the difference was statistically significant(p<0.05).② Wound bacterial culture results:Before treatment and 7 days after the first treatment,the number of patients with positive wound bacterial culture in aseptic biofilm group was 6 cases(28.57%)and 2 cases(9.52%).and the number of patients with positive wound bacterial culture in control group was 7 cases(33.33%)and 4 cases(19.05%).There was no statistically significant difference between the two groups before treatment(p>0.05).Seven days after treatment,the positive rate of wound bacterial culture in the two groups decreased,and the difference was statistically significant(p<0.05).③VAS score of wound dressing change:the VAS score of patients in aseptic biofilm group was(3.86±1.19)points,and the VAS score of patients in mesh gauze group was(5.10±1.13)points,there was statistically significant difference between the two groups(p<0.05).④Survival of skin graft and flap:after autologous skin graft and flap transplantation,the excellent and good survival rate of skin graft and flap in the surgical area of patients in aseptic biofilm group was 95.23%.In the control group,the excellent and good survival rate of skin graft flap in the operation area was 76.19%.The difference between the two groups was statistically significant(p<0.01).⑤The incidence of adverse events during the treatment:the incidence of adverse reactions in the aseptic biofilm group(9.52%)was lower than that in the control group(23.81%),and the difference between the two groups was statistically significant(p<0.05).⑥Postoperative follow-up and Vancouver Scar Scale scores:the incidence of skin ulceration in the surgical area of the aseptic biofilm group was lower than that of the control group,and the difference was statistically significant(p<0.05).The VSS score of the aseptic biofilm group(2.85±1.24)was lower than that of the control group(3.57±0.98),and the difference was statistically significant(p<0.05).Conclusion Aseptic biofilm can temporarily protect the wound,shorten the time of wound base preparation,relieve wound pain,reduce the occurrence of adverse reactions,reduce the degree of scar formation after operation,and reduce the rate of skin ulceration.It is a good biological dressing that can effectively treat severe trauma wounds by accelerating preparation of wound substrate and is worthy of further application in clinical treatment. |
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