伤后一周内完成烧伤切除的意义

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2025-04-17 DOI:10.1016/j.burns.2025.107506

Yasuhiko Kaita, Takeaki Matsuda, Yoshihiro Yamaguchi

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引用次数: 0

摘要

背景：烧伤创面切除是控制烧伤患者感染的关键。根据以往的研究，日本烧伤学会建议烧伤面积30% %及以上的患者应在伤后一周内完成手术清创。然而，还没有报道检查在一周内完成烧伤创面切除的意义。本研究旨在阐明30% %或以上的火焰烧伤患者在伤后一周内完成烧伤切除的重要性。方法回顾性分析2005年1月至2024年12月66例火焰烧伤手术切除患者的资料。结果完成组与未完成组在年龄、性别、烧伤严重程度、是否存在吸入性损伤、使用尸体皮、ICU住院时间等方面差异无统计学意义。损伤后两周内，完成组菌血症的发生率明显低于未完成组，完成组的死亡率低于未完成组。在logistic回归分析中，一周内完成烧伤切除与菌血症的发生率独立相关，但与死亡率无关。结论对于烧伤总面积≥30% %的火焰烧伤患者，在一周内完成烧伤切除术是控制感染的重要措施。

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The significance of completing burn excision within one week after injury

Background

Burn wound excision is crucial for infection control in burn patients. Based on previous studies, the Japanese Society of Burn Injuries recommended that the surgical debridement be completed within one week after injury for patients with a burned area of 30 % or more. However, there have been no reports examining the significance of completing resection of the burn wound within one week. This study was aimed to clarify the importance of completing burn excision within one week after injury for 30 % or more in flame burn patients.

Methods

Data from 66 flame burn patients who underwent surgical excision from January 2005 to December 2024 were analyzed retrospectively.

Results

There were no significant differences between the completed and uncompleted groups in terms of age, sex, severity of burn, the presence of inhalation injury, the use of cadaver skin, and the ICU length of stay. The presence of bacteremia within two weeks after injury was significantly lower in the completed group compared to the uncompleted group, and the mortality rate in the completed group was lower than that of the uncompleted group. In the logistic regression analysis, the completion of burn excision within one week was independently associated with the incidence of bacteremia but not mortality.

Conclusions

Completing burn excision within one week is important for infection control in flame burn patients with the total burn surface area of 30 % or more.

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.