Ⅱ度烧伤创面治疗专家共识（2024版）Ⅰ：院前急救和非手术治疗

中华医学会烧伤外科学分会; 海峡两岸医药卫生交流协会暨烧创伤组织修复专委会

doi:10.3760/cmaj.cn501225-20231019-00120

Ⅱ度烧伤创面治疗专家共识（2024版）Ⅰ：院前急救和非手术治疗
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doi: 10.3760/cmaj.cn501225-20231019-00120

基金项目:

中国医学科学院医学与健康科技创新工程项目 2019-I2M-5-076

上海市重中之重研究中心项目 2023ZZ02013

国家自然科学基金重点项目 81930057

国家自然科学基金面上项目 81971836

上海市优秀学术带头人项目 23XD1425000

详细信息

通信作者：夏照帆，海军军医大学第一附属医院烧伤外科，全军烧伤研究所，中国医学科学院烧伤暨烧创复合伤救治关键技术创新单元，上海 200433，Email： xiazhaofan@163.com

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出版历程
- 收稿日期: 2023-10-19

Expert consensus on the treatment of second-degree burn wounds (2024 edition)Ⅰ: pre-hospital first aid and non-surgical treatment

Funds:

Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences 2019-I2M-5-076

Shanghai Top Priority Research Center Project 2023ZZ02013

Key Program of National Natural Science Foundation of China 81930057

General Program of National Natural Science Foundation of China 81971836

Program of Shanghai Academic Research Leader 23XD1425000

摘要

摘要:
Ⅱ度烧伤是临床中最为常见但处理十分棘手的烧伤类型。目前关于Ⅱ度烧伤创面的急救、诊断、分类、保守换药的方式、外用敷料或药物的选择等尚未形成统一的标准和规范，严重影响临床治疗方案的制订及临床研究开展的一致性。本共识编写组以循证医学证据为基础，结合专家意见，制订《Ⅱ度烧伤创面治疗专家共识（2024版）Ⅰ：院前急救和非手术治疗》。本共识从Ⅱ度烧伤创面的早期急救和非手术治疗2个方面提出29条具体推荐意见，旨在形成规范的Ⅱ度烧伤创面临床治疗方案。
- 烧伤 /
- 急救 /
- 创面处理 /
- 专家共识
Abstract:
Second-degree burn is the most common type of burns in clinical practice and hard to manage. At present, there is no unified standard or specification for the first aid, diagnosis, classification, manner of conservative dressing change, and choice of external dressings or medications for second-degree burn wounds, which significantly affects the formulation of clinical treatment plans and the consistency of clinical studies. The consensus writing group developed the Expert consensus on the treatment of second-degree burn wounds (2024 edition) Ⅰ : pre-hospital first aid and non-surgical treatment based on evidence-based medicine evidence and expert opinion. This expert consensus put forward 29 specific recommendations from 2 aspects: pre-hospital first aid and non-surgical treatment for second-degree burn wounds, aiming to form a standardized clinical treatment plan for second-degree burn wounds.
- Burns /
- First aid /
- Wound management /
- Expert consensus
所有编写组成员均声明不存在利益冲突，无商业组织向本共识编写组支付费用。本共识制订过程中需要的资金均来自本文著录的基金项目，且推荐意见未受资助影响

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表1 基于GRADE系统的证据质量等级及描述

表1. Evidence quality level and description based on GRADE system

证据质量等级	描述
高	非常确信效应估计值接近真实效应值
中	对效应估计值有中等程度的信心，效应估计值可能接近真实效应值，但仍存在二者大不相同的可能性
低	对效应估计值的确信程度有限，效应估计值可能与真实效应值大不相同
注：GRADE为推荐意见分级的评估、制订和评价；证据质量等级可因存在偏倚风险、研究结果不一致或发表偏倚而降低，可因疗效显著或存在明显剂量-效应关系而升高

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表2 Ⅱ度烧伤创面的分类及特点

表2. Classification and characteristics of second-degree burn wounds

深度	损伤组织层次	外观表现	触觉特征	愈合时间	愈合后瘢痕增生情况
浅Ⅱ度	表皮及真皮浅层	有红斑、水疱，创基有渗出	疼痛明显，按压创基发白	<2周	一般无瘢痕
偏浅深Ⅱ度	表皮及真皮中层	深粉色，有水疱，创基湿润或干燥	疼痛或痛觉消失，按压创基不发白	2~3周	瘢痕发生率约为30%
偏深深Ⅱ度	表皮及真皮深层	红白相间，可有水疱，创基湿润或干燥	疼痛或痛觉消失，按压创基不发白	>3周	瘢痕发生率为70%~80%