MEBT/MEBO結(jié)合鉆孔術(shù)治療大面積脛骨外露1例報告

摘要： 目的介紹燒傷皮膚再生醫(yī)療技術(shù)(MEBT/MEBO)結(jié)合鉆孔術(shù)在重度燒傷伴脛骨大面積骨外露患者中的使用情況及臨床療效。方法采用燒傷皮膚再生醫(yī)療技術(shù)處理燒傷創(chuàng)面,用MEBO敷料覆蓋創(chuàng)面并無壓包扎,每日換藥1次。對外露脛骨實行鉆孔手術(shù)培養(yǎng)肉芽組織后再行植皮手術(shù)治療。結(jié)果分別于患者入院后6周、10周行植皮手術(shù)封閉肉芽創(chuàng)面,整個病程中,患者有3 d的中度發(fā)熱,未并發(fā)細菌及真菌感染。結(jié)論使用MEBT/MEBO治療燒傷創(chuàng)面,能保證創(chuàng)面濕潤不干燥,壞死組織易于清除,清創(chuàng)時間短,患者痛苦小;通過骨鉆孔術(shù)能在光滑的骨面上培養(yǎng)肉芽組織,后期只需郵票式植皮即可封閉創(chuàng)面,避免了截肢。
Objective To introduce the application situation and clinical efficacy of MEBT/MEBO in combination with drilling in the treatment of major burns combined with extensive tibia exposure.Methods Use MEBT to manage burn wounds and make MEBO dressing to cover the wounds and then bandage them without pressure.Change dressing once per day.Perform drilling on the exposed tibia to culture granulation and later perform skin grafting.Results Perform skin grafting to close the granulation wound in 6th and 10th week respectively.During the whole treatment course,the patient developed moderate fever for three days but no general or fungus infection occurred.Conclusion MEBT/MEBO in the treatment of burns can guarantee the wound moist without dehydration,facilitate the dissolution of eschar on the necrotic tissue, shorten the debridement time and reduce patients' pain.Drilling can help culture granulation tissue on the smooth bone surface and the wound can be closed simply by stamp-like skin grafting at the later stage,so amputation can be avoided.