Clinical controlled study on the escharectomy and delayed operation of the burn wounds during the stage of sepsis shock
10.3969/j.issn.1009-0754.2016.02.014
- VernacularTitle:烧伤脓毒症休克期创面切痂手术与延期手术的临床对照研究
- Author:
Fengrui XU
1
;
Mingwu HE
Author Information
1. 湖北医药学院附属医院烧伤整形科
- Keywords:
Sepsis;
Shock stage;
Wound;
Escharectomy
- From:
Journal of Navy Medicine
2016;37(2):143-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and necessity of escharectomy and skin graft in sepsis shock stage in burn patients.Methods Fifty-two patients with large area burns coupled with sepsis, hospitalized for treatment from September, 2008 to December, 2014 in our hospital were selected for the study.When the patients displayed signs of shock, they were given anti-shock treatment and at the same time received escharectomy and skin grafting.Collection of medical data was made in 25 severe burn patients, who had delayed escharectomy during sepsis stage and received surgery when the state of illness became stable.Comparisons were made between the 2 groups in the indices of postoperative organ function ( creatinine, ALT) , blood analysis, postoperative plasma PCT ( Pro-calcitonin) and interleukin 6 ( IL-6) levels, as well as wound healing rate and postoperative blood lactic acid level, incidence of multi-ple organ dysfunction syndrome ( MOD) and mortality rate.Results The levels of PCT and IL-6 after surgery for the escharectomy group were decreased, and the state of illness was stable.Incidence of MODS after surgery and mortality were significantly lower than those of the delayed escharectomy group, and the indices of organ functions as well as wound healing rate were all significantly superior to those of the delayed escharectomy group.Conclusion To the burn patients at sepsis shock stage, active anti-shock measures coupled with escharectomy and skin grafting, removal of the necrotic tissue could not only decrease mortality, increase cure rate, decrease inva-sive wound infection, but shorten the course of disease, reduce incidence of MODS and mortality, thus increasing cure rate.
