Application of Barker sterile dressing in the repair of foot skin necrotic defects in children
巴克无菌敷贴在小儿足部皮肤坏死缺损修复中的应用

摘要

目的 探讨应用巴克无菌敷贴修复小儿足部皮肤坏死的临床效果。方法 对2016年12月至2020年10月河北唐山巴克医院创面修复中心采用巴克无菌敷贴治疗的小儿足部皮肤坏死患儿11例的临床资料进行回顾性分析。其中男6例，女5例，平均年龄6（1～12）岁；均为外伤致足部皮肤坏死，皮肤坏死面积为1.5cm×2.6cm～10.0cm×25.0cm。采用巴克无菌敷贴局部换药处理创面。记录创面愈合时间、观察愈合后的瘢痕评分、创面愈合后皮肤色泽和质地及足部功能恢复情况。结果 所有创面均完全愈合，未出现感染病例。愈合时间最短8天，最长90天，平均27天。随访时间6月～24月，平均18个月；瘢痕增生轻度10例，中度1例；创面愈合后皮肤色泽分级：显效9例，有效2例；质地分级：显效10例，有效1例。术后3个月肿胀基本消退，色泽红润，皮肤平整，有弹性，未见明显色素沉着，外观良好。术后2年愈合的皮肤颜色接近正常，平滑柔软，无明显瘢痕增生和挛缩，有明显的触痛觉，无反复破溃病例。足部功能均为优，患儿家属对足部外形及功能恢复表示满意。结论 应用巴克无菌敷贴修复小儿足部皮肤坏死，是一种安全、有效的修复方法，可获得良好的临床效果。

Abstract

Objective To explore the clinical effect of barker sterile dressing to repair foot skin necrosis in children.
Methods The clinical data of 11 children with foot skin necrosis treated from December 2016 to October 2020. Among them, 6 males and 5 females with mean age of 6 (1～12) years; all were foot skin necrosis caused by trauma, with skin necrosis area of 1.5 cm ×2.6cm～10.0 cm 25.0 cm. The wound was treated with sterile dressing. The wound healing time, the healing scar score, skin color and texture and foot function recovery were recorded.
Results All wounds healed completely with no cases of infection. The minimum healing time was 8 days and 90 days, with an average of 27 days. The follow-up period was June to 24 months, average 18 months; 10 cases of mild scar hyperplasia, 1 moderate; skin color grade after wound healing: 9 cases and effective in 2; texture grade: 10 cases and 1 effective. Three months after the operation, the swelling basically subsided, the color was ruddy, the skin was smooth, elastic, no obvious pigmentation, and good appearance. The skin healed at 2 years after surgery was nearly normal, smooth and soft, with no obvious scar hyperplasia and contracture, obvious palpation, and no cases of recurrent rupture. The foot function was excellent, and the families of the children were satisfied with the appearance and function recovery of the foot.
Conclusion   Using barker sterile dressing to repair foot skin necrosis in children is a safe and effective repair method with good clinical results.