| Hayam Sabry,Hussein Saber,Raouf Gomaa,Iman Labib,Hassan Kholousy,Mahmoud Sakr,Souad Farid.MEBT/ MEBO治疗5岁以下儿童烧伤疗效评估[J].中国烧伤创疡杂志,2017,(4):229~241. |
| DOI： |
| 中文关键词: 再生疗法 烧伤再生医疗技术 湿润环境 烧伤 感染 儿童 创面愈合 |
| 英文关键词:Regenerative therapy MEBT/ MEBO Moist environment Burns Children Wound healing |
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| 中文摘要: |
| 【摘要】 目的 评估烧伤再生医疗技术(moist exposed burn therapy/ moist exposed burn ointment, MEBT/MEBO) 治疗儿童Ⅱ ~ Ⅲ度烧伤创面的临床疗效和安全性?方法 2015 年9 月—2016 年8 月埃及亚历山大大学总医院烧伤科收治的20 例5 岁以下Ⅱ度和/ 或Ⅲ度烧伤患儿, 均于入院后在全身综合治疗的基础上接受MEBT/MEBO治疗局部创面, 其中Ⅱ度烧伤创面每天换药3 次, 直至创面愈合; Ⅲ度烧伤创面每天换药3 次, 待创面肉芽组织生长良好后, 予以植皮术封闭创面?观察肉芽组织形成时间?创面愈合时间?瘢痕增生情况及药物不良反应, 并检测治疗过程中创面细菌感染情况?结果 肉芽组织的形成时间为10 ~19 d; 浅Ⅱ度烧伤创面愈合时间为6 ~7 d, 愈后皮肤弹性正常, 无明显瘢痕增生及色素沉着; 深Ⅱ度烧伤创面愈合时间为14 ~19 d, 除2 例患儿部分愈后皮肤留有非增生性软瘢痕外, 其余患儿愈后皮肤均未见明显瘢痕增生; Ⅲ度烧伤创面均进行了皮肤移植,愈合情况良好; 治疗3 周后患儿创面感染率由入院时的70%下降至0; 治疗过程中所有患儿均未出现药物不良反应; 随访6 个月, 所有四肢烧伤患儿均无四肢功能障碍及畸形?结论 MEBT/ MEBO 治疗儿童Ⅱ ~ Ⅲ度烧伤, 可有效促进Ⅱ度烧伤创面的生理性再生愈合, 恢复皮肤的正常组织结构及功能, 避免植皮; 可显著促进Ⅲ度烧伤创面焦痂的液化脱离以及肉芽组织的早期生长, 为皮肤移植做好准备, 提高移植皮片的成活率; 可有效抑制细菌生长, 防治创面感染; 操作简便?安全可靠, 可有效降低过敏反应及副反应的发生率? |
| 英文摘要: |
| 【Abstract】 Objective To assess the efficacy and safety of burn regenerative therapy (BRT) using MEBT/ MEBO(SanTou MEBO Pharmaceutical Co, Ltd, China, and Gulf Pharmaceutical industries Julphar, UAE) in healing of second and third-degree burns in children. Methods The study population included 20 consecutive burned children up to 5 years,admitted to the Burn Unit of Alexandria University Main Hospital, Egypt, from September 2015 to August 2016, with 2nd-and/ or 3rd-degree burns, up to 20% total burn surface area (TBSA). All patients were treated with MEBT/ MEBO dressing
every 8 hours. Burn wound surface moist swabs were taken from all children at weekly intervals and tissue biopsy was taken from deep burns only. The following was recorded during hospital say; sepsis, wound discharge, time of eschar separation and formation of granulation tissue, healing rate, need of skin graft, drug reactions and duration of hospital stay. Duringfollow-up (6 months) assessment included final scar quality and appearance, deformity, graft take, and organ function.Results Superficial 2nd-degree burns healed within one week with normal skin elasticity, no scar formation and no obvious pigmentation. Deep 2nd-degree burns healed within 2 - 3 weeks with normal skin except in 2 two children who developed Nonhhyperplastic scars in some areas. Skin grafting (with 100% take) was required in children with 3rd-degree burns only.The hospital stay was 5 -21 days. No drug reaction was seen and, in burns of the extremities, no disturbance of function or deformity was encountered. The commonest organisms cultured were Pseudomonas Aeruginosa and MRSA, alone or in com?bination. Cultures of the first sample were negative in 6 children (30%) and showed mono?microbial infection in 8 children(40%) and poly-microbial in six (30%). Positive bacterial cultures were reduced from a total of 70% at the first sample to 0% by the end of the 3rd week post-treatment.Conclusion (1) all partial and deep 2nd-degree burns heal spontane-ously with normal skin (2) good debridement, rapid eschar liquefaction and early granulation tissue formation in 3rd-degree burns is achieved, with complete take of skin grafts, (3) there is a definite anti-microbial action, effective against resistant organism, and (4) MEBT/ MEBO is safe, easy to apply, and ensures continuous supply of the drug to the burn wound keeping a physiological moist environment and supplying indispensable nutritional substrates and enzymes necessary for physiological wound healing. |
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