A Retrospective Analysis of Securing Meek Skin Grafting with Negative Pressure Wound Therapy in Major Burn Patients in the Formosa Fun Coast Dust Explosion Disaster

八仙塵爆事件中大面積燒傷患者使用Meek微粒皮膚植皮合併負壓式傷口治療

瞿子翔(Tzi-Shiang Chu) ； 吳建儒(Chien-Ju Wu) ； 張鈞凱(Chun-Kai Chang) ； 陳俊宇(Chun-Yu Chen) ； 王啟宇(Chi-Yu Wang) ； 周昌益(Chang-Yi Chou) ； 喬浩禹(Hao-Yu Chiao) ； 王志信(Chih-Hsin Wang) ； 戴念梓(Niann-Tzyy Dai) ； 曾元生(Yuan-Sheng Tzeng)

《臺灣整形外科醫學會雜誌》 26卷1期 (2017/03) Pp. 73-81

摘要

Background: For covering skin defects in extensive full-thickness burn injuries, the Meek skin graft was found effective. In the past, the skin graft used to be secured with tie-over bolster dressing. However, negative pressure wound therapy (NPWT) is now the new choice. Aim and objectives: We applied NPWT to secure the Meek skin graft to reduce the incidence of regrafting. Materials and methods: A retrospective single-center study was conducted to demonstrate our experience in the fixation of Meek skin graft on burn wounds by using NPWT in patients who incurred extensive burns in the Formosa Fun Coast Dust Explosion Disaster. Results: Eight patients received Meek skin graft secured with NPWT. The mean age of the patients was 22.375 years. The mean body surface involvement was 69.875%, and the mean area of third-degree burns was 54.875%. The mean Baux score of the patients was 92.25. The mean size of the graft used for each patient was 6276 cm2 (between 4500 and 9550 cm2). Regrafting was not needed for the Meek skin graft after the primary operation. None of the patients in this study died during the study period. Conclusions: In extensive burn injuries, the Meek technique of skin expansion secured with NPWT efficiently and effectively covered open wounds. When the intact skin is limited, the use of a Meek skin graft should be considered. It helped to decrease the rate of regrafting, mortality, and the loading of workers in the multiple casualty incident.

關鍵字

negative pressure wound treatment ； extensive burn ； meek skin graft

並列摘要

背景：對於大面積燒傷的患者，Meek微粒皮膚植皮手術可以有效的治療。過去我們使用綁線方式固定植皮，現在我們有了負壓傷口治療裝置這個新選擇。目的及目標：利用負壓傷口治療裝置確保Meek微粒皮膚植皮生長，降低再植皮機率。材料及方法：這是一個回朔性單一中心的研究，顯示在八仙塵爆事件中嚴重燒傷的病人，使用負壓傷口治療裝置固定Meek微粒皮膚植皮的經驗。結果：共八位患者接受負壓傷口治療裝置固定Meek微粒皮膚植皮。患者平均年齡22.375歲，平均燒傷體表面積為69.875%，三度燙傷佔體表面積54.875%，平均Baux分數92.25，平均植皮面積6276.25平方公分，無患者需要再次植皮，無患者死亡。結論：在嚴重燒燙傷的病人中，使用負壓傷口治療裝置固定Meek微粒皮膚植皮能有效率的達到傷口附蓋的效果。在皮膚不足的情況，可以考慮使用Meek微粒皮膚植皮。這個方法可以降低重新植皮與患者死亡的機率，也可以減輕團隊成員於大量傷患事件中的工作負擔。