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Title: [Experience of wound treatment on extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident].
Author: Shou BM, Tan Q, Sun BW, Nie LJ, Shen YM, Lyu GZ, Zhang Y, Lin W, Wang ZX, Yu Y, Zhao YH, Wang DW, Yao J, Xie EF, Zheng DF, Xiao SC, Zhang HW, Hong ZJ, Wang L, Xie WZ.
Journal: Zhonghua Shao Shang Za Zhi; 2018 Jun 20; 34(6):339-342. PubMed ID: 29961289.
Abstract:
Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions: Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin. 目的： 探讨"八二"昆山工厂铝粉尘爆炸事故群体特重度烧伤患者创面处理经验。 方法： 2014年8月2日，98例"八二"昆山工厂铝粉尘爆炸事故中的群体特重度烧伤患者收入全国20家医院，病历资料完整纳入本研究，根据手术方式分为微粒植皮组56例患者和Meek植皮组42例患者，于残存皮肤区域切取刃厚皮，分别采用微粒皮移植和Meek微型皮片移植方式进行创面修复。回顾性统计2组患者伤后28 d未封闭创面面积、术后创面感染情况及患者供皮区总体来源。对数据行t检验及χ(2)检验。 结果： Meek植皮组患者伤后28 d未封闭创面面积为(59±13)%TBSA，明显小于微粒植皮组的(70±14)%TBSA(t＝4.379，P<0.05)。术后微粒植皮组中29例患者创面明显感染，Meek植皮组中11例患者创面明显感染。2组患者除了取头皮、躯干、腹股沟及腋窝等处创面周边残存皮肤修复创面外，还从阴囊(4例)、足底(10例)、趾/指蹼(8例)等非常规供皮区取皮修复创面。 结论： 群体特重度烧伤患者首选Meek植皮修复创面，可使创面愈合加快、感染情况减少，皮源奇缺的情况下可从阴囊、足底、趾/指蹼等非常规供皮区取皮进行创面修复。.

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