目的:分析医院烧伤整形外科烧伤感染患者标本中病原菌的分布及其耐药情况,为临床烧伤感染患者的防治提供参考.方法:选取 2019 年 4 月—2021 年 4 月医院烧伤整形外科收治的 109 例烧伤感染患者作为研究对象,采集患者标本(创面分泌物、血液、痰液等)的病原菌培养及药敏试验结果,分析患者标本中病原菌的分布及其耐药情况.结果:109 例烧伤感染患者各标本中培养、分离出 223 株病原菌,其中革兰阴性菌140 株(占 62.78%,位列前 3 的分别为肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌)、革兰阳性菌 78 株(占 34.98%,位列前 3 的分别为金黄色葡萄球菌、凝固酶阴性葡萄球菌和粪肠球菌)和真菌 5 株(占 2.24%);药敏结果显示,肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率均较低(＜10.00%),铜绿假单胞菌、鲍曼不动杆菌对阿米卡星的耐药率亦较低(＜20.00%);金黄色葡萄球菌、凝固酶阴性葡萄球菌和粪肠球菌对利奈唑胺、万古霉素的耐药率极低(＜10.00%);金黄色葡萄球菌、凝固酶阴性葡萄球菌对莫西沙星的耐药率较低(≤20.00%),对其他抗菌药物的耐药率均各不相同;白假丝酵母对制霉菌素、伊曲康唑和氟胞嘧啶的耐药率均为 0.00%.结论:烧伤感染患者感染病原菌主要以革兰阴性菌为主,且其对抗菌药物普遍呈现多重耐药,临床应结合药敏试验结果选用敏感率高的抗菌药物治疗,以有效控制其感染,确保其疗效.
目的 探讨手指背侧热压伤创面患者采用指固有动脉穿支皮瓣+掌背动脉穿支皮瓣接力修复治疗的临床效果.方法 选取2019年01月—2022年6月期间收治的30例手指背侧热压伤创面患者进行回顾性分析,根据不同的治疗方法进行分组,采用腹部带蒂皮瓣移植修复术治疗的患者纳入对照组(n=15),采用指固有动脉穿支皮瓣+掌背动脉穿支皮瓣接力修复治疗的患者纳入观察组(n=15),治疗后进行6个月随访,对比两组的手术次数,住院时间,手功能优良率和并发症发生率.结果 观察组的手功能优良率较对照组高(P<0.05);观察组的并发症发生率较对照组低(P<0.05).结论 手指背侧热压伤创面患者采用指固有动脉穿支皮瓣+掌背动脉穿支皮瓣接力修复治疗的效果较显著,能有效推动手功能的恢复,减少术后并发症的发生,临床可进一步推广.
Objective To investigate the effect of skin and soft tissue expansion in the plastic surgery of burn scar deformity on wound healing and complications. Methods From March 2018 to March 2022, 68 burn patients were selected and divided into a study group（34 cases） and a control group（34 cases）. The study group was treated with skin and soft tissue expansion, while the control group was treated with composite skin grafting. The wound healing time, complications, blood supply recovery time, and wound satisfication of the two groups were compared and analyzed. Results The wound healing time and blood supply recovery time in the study group were shorter than those in the control group（P＜0.05）, and the incidence of complications in the study group was lower than that in the control group（P＜0.05）. The satisfaction with the wound in the study group was higher than that in the control group（P ＜0.05）.Conclusion The application of skin and soft tissue expansion in burn scar deformity plastic surgery can effectively shorten the time of wound healing and blood supply recovery, and improve patients’ satisfaction with the wound. It is safe and can be clinically promoted.
