Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns

Fu Qingqing; Li Maojun; Huang Ling; Tan Jianglin; Zhou Yaqin; Li Ning

doi:10.3760/cma.j.cn501120-20210323-00101

Volume 38 Issue 10

Oct. 2022

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(10): 952-958

Fu QQ,Li MJ,Huang L,et al.Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns[J].Chin J Burns Wounds,2022,38(10):952-958.DOI: 10.3760/cma.j.cn501120-20210323-00101.

Citation:

PDF( 2669 KB)

Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns

doi: 10.3760/cma.j.cn501120-20210323-00101

State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China

Funds:

Military Nursing Innovation and Cultivation Special Project 2021HL008

More Information

Corresponding author: Li Ning, Email: 335405006@qq.com
Received Date: 2021-03-23

Abstract

Abstract

Objective To explore the clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns. Methods The retrospective case-control research approach was used. From January to December 2019, 109 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) within 1 week after deep burn wound healing on the face and neck. Fifty-five patients who were admitted to the hospital from January to June and received comprehensive treatment and conventional nursing were included in conventional nursing group (27 males and 28 females, aged 21-65 (40±17) years), and fifty-four patients who were admitted to the hospital from July to December and received comprehensive treatment and sequential nursing were included in sequential nursing group (29 males and 25 females, aged 18-57 (37±11) years). The scores of pigmentation, vascularity, pliability, and thickness in Vancouver scar scale (VSS), the total score of VSS, the score of itch's impact on sleep in the four-item itch questionnaire (FIIQ), and the total score of FIIQ of patients were counted in the two groups before the first treatment (hereinafter referred to as treatment) and 3 months, 6 months, and 1 year after treatment. The treatment effective rate and the score of patients' satisfaction with the treatment effect in one year after treatment and the occurrence of adverse reaction during the treatment were counted. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. Results The scores of pigmentation, vascularity, pliability, and thickness in VSS and the total VSS score of patients between the two groups before treatment were close (P>0.05). The pliability score in VSS and total VSS score after 3 months of treatment, the score of vascularity in VSS and total VSS score after 6 months of treatment, and the scores of pigmentation, vascularity, pliability, and thickness in VSS and total VSS score of patients after 1 year of treatment in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -2.51, -3.37, -2.05, -3.28, -3.12, -5.86, -4.63, -5.56, -6.76, respectively, P<0.05 or P<0.01). The score of itch's impact on sleep in FIIQ after 3 months of treatment of patients in sequential nursing group was significantly lower than that in conventional nursing group (Z=-4.17, P<0.01), and the total scores of FIIQ after 3 months, 6 months, and 1 year of treatment of patients in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -6.56, -5.53, -5.84, respectively, P<0.01). After 1 year of treatment, the treatment effective rate of patients in sequential nursing group was 96.3% (52/54), which was significantly higher than 81.8% (45/55) in conventional nursing group (χ²=5.83, P<0.05), and the score of patients' satisfaction with the treatment effect in sequential nursing group was significantly higher than that in conventional nursing group (Z=-4.49, P<0.01). During the treatment period, there was no adverse reaction in patients in sequential nursing group, but there were 3 patients with pruritus and peripheral erythema on the wound in conventional nursing group, which were improved after dressing changes. Conclusions Sequential nursing can effectively improve the prevention and management of new skin scars in patients after deep burns on the face and neck, improve the itching, the efficiency of treatment, and the satisfaction of patients with the treatment effect.
- Burns,
- Cicatrix,
- Face and Neck,
- New skin management,
- Sequential nursing

FullText(HTML)

References(32)

References

[1]	蒋春燕,李丹,张建梅,等.康复护理促进烧伤患者生活质量的Meta分析[J].中国康复理论与实践,2016,22(3):345-349.DOI: 10.3969/j.issn.1006-9771.2016.03.024.
[2]	TianH,WangL,XieW,et al.Epidemiologic and clinical characteristics of severe burn patients:results of retrospective multicenter study in China,2011-2015[J/OL].Burns Trauma,2018,6: 14[2021-12-02].https://pubmed.ncbi.nlm.nih.gov/29850643/.DOI: 10.1186/s41038-018-0118-z.
[3]	冯苹,夏照帆,张玲娟. 烧伤患者生存质量现状与研究进展[J]. 中华护理杂志,2011,46(4):419-421. DOI: 10.3761/j.issn.0254-1769.2011.04.044.
[4]	LobodaTV, FrenchN, Hight-HarfC, et al. Mapping fire extent and burn severity in Alaskan tussock tundra: an analysis of the spectral response of tundra vegetation to wildland fire[J]. Remote Sensing of Environment, 2013, 134(Complete):194-209. DOI: 10.1016/j.rse.2013.03.003.
[5]	张媛媛,朱晓丹,耿燕婷,等.综合康复护理在面部深Ⅱ度烧伤后瘢痕防治中的应用效果[J].中华现代护理杂志,2016,22(19):2740-2743.DOI: 10.3760/cma.j.issn.1674-2907.2016.19.020.
[6]	黎宁,王丽华.早期多学科团队康复治疗模式在大面积烧伤患者中的应用及效果分析[J].中国护理管理,2018,18(1):125-129.DOI: 10.3969/j.issn.1672-1756.2018.01.030.
[7]	张秀妮,胡爱玲.颜面部烧伤瘢痕患者的残障接受度现状及影响因素分析[J].当代护士(上旬刊),2020,27(10):40-43.DOI: 10.19791/j.cnki.1006-6411.2020.28.016.
[8]	MagnaniDM,SassiFC,VanaLPM,et al.Orofacial rehabilitation after severe orofacial and neck burn: experience in a Brazilian burn reference centre[J].Burns,2021,47(2):439-446.DOI: 10.1016/j.burns.2020.07.011.
[9]	TracyLM,EdgarDW,SchraleR,et al.Predictors of itch and pain in the 12 months following burn injury: results from the Burns Registry of Australia and New Zealand (BRANZ) long-term outcomes project[J/OL].Burns Trauma,2020,8:tkz004[2021-12-02]. https://pubmed.ncbi.nlm.nih.gov/32346541/.DOI: 10.1093/burnst/tkz004.
[10]	郭晓雨, 谢卫国. 烧伤后创面皮肤色素沉着障碍机制的研究进展 [J] . 中华烧伤杂志, 2021, 37(10) : 1000-1004. DOI: 10.3760/cma.j.cn501120-20200714-00344.
[11]	FuX,DongJ,WangS,et al.Advances in the treatment of traumatic scars with laser, intense pulsed light, radiofrequency, and ultrasound[J/OL].Burns Trauma,2019,7:1[2021-12-02].https://pubmed.ncbi.nlm.nih.gov/30723753/.DOI: 10.1186/s41038-018-0141-0.
[12]	黎燕丽,张秀妮,苏庆玲.综合康复护理对大面积烧伤患者生活质量的影响[J].中国临床护理,2018,10(2):136-138.DOI: 10.3969/j.issn.1674-3768.2018.02.013.
[13]	安群.颜面烧伤后皮肤康复治疗频次与疗效观察研究[J].反射疗法与康复医学,2020,29(12):91-93.DOI: 10.19589/j.cnki.issn2096-7950.2020.12.091.
[14]	GreenhalghDG.Management of facial burns[J/OL].Burns Trauma,2020,8:tkaa023 [2021-10-08].https://pubmed.ncbi.nlm.nih.gov/32665953/.DOI: 10.1093/burnst/tkaa023.
[15]	FloresO,TyackZ,StocktonK,et al.The use of exercise in burns rehabilitation: a worldwide survey of practice[J].Burns,2020,46(2):322-332.DOI: 10.1016/j.burns.2019.02.016.
[16]	TanJ,ChenJ,ZhouJ,et al.Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis[J/OL].Burns Trauma,2019,7:17[2021-12-02].https://pubmed.ncbi.nlm.nih.gov/31139664/.DOI: 10.1186/s41038-019-0151-6.
[17]	Forbes-DuchartL,MarshallS,StrockA,et al.Determination of inter-rater reliability in pediatric burn scar assessment using a modified version of the Vancouver Scar Scale[J].J Burn Care Res,2007,28(3):460-467.DOI: 10.1097/BCR.0b013E318053D3BB.
[18]	雷颖,吴溯帆,李文志,等.增生性瘢痕激光治疗的应用与进展[J].中国激光医学杂志,2016,25(6):374-378.DOI: 10.13480/j.issn1003-9430.2016.0374.
[19]	牛晓暐,李彬,程金莲,等.桃红四物汤加味联合针刺治疗烧伤后创面瘙痒[J].中医学报,2019,34(10):2245-2249.DOI: 10.16368/j.issn.1674-8999.2019.10.518.
[20]	吴丽珍,后晨蓉,谢振谋,等.曲安奈德联合玻璃酸酶注射辅助浅层X线放射治疗多发性瘢痕疙瘩的有效性研究[J].中华整形外科杂志,2021,37(1):79-83.DOI: 10.3760/cma.j.cn114453-20200624-00384.
[21]	张玉婷, 李攀, 罗伦, 等. 烧伤患者瘢痕重塑期增生性瘢痕机械信号转导分子与伤后时间的相关性研究 [J] . 中华烧伤杂志,2018,34 (10): 690-695. DOI: 10.3760/cma.j.issn.1009-2587.2018.10.008.
[22]	XiangJ,YangQ,XieWG,et al.Evaluating the impact of rehabilitation nursing intervention on quality of life in patients with burn injuries: a protocol for systematic review and meta-analysis[J].Medicine (Baltimore),2021,100(1):e23879.DOI: 10.1097/MD.0000000000023879.
[23]	孙林利,孙丽娟,何珍珍,等.基于TTM的康复护理方案对颜面部烧伤病人歧视感及伤残接受度的影响[J].护理研究,2021,35(11):2006-2009.DOI: 10.12102/j.issn.1009-6493.2021.11.028.
[24]	RohYS,ChoH,OhJO,et al.Effects of skin rehabilitation massage therapy on pruritus, skin status, and depression in burn survivors[J].Taehan Kanho Hakhoe Chi,2007,37(2):221-226.DOI: 10.4040/jkan.2007.37.2.221.
[25]	LeeKC,DretzkeJ,GroverL,et al.A systematic review of objective burn scar measurements[J/OL].Burns Trauma,2016,4:14[2021-10-08]. https://pubmed.ncbi.nlm.nih.gov/27574684/. DOI: 10.1186/s41038-016-0036-x.
[26]	ShirakamiE, YamakawaS, HayashidaK.Strategies to prevent hypertrophic scar formation: a review of therapeutic interventions based on molecular evidence[J/OL].Burns Trauma,2020,8:tkz003[2021-12-02].https://pubmed.ncbi.nlm.nih.gov/32341924/.DOI: 10.1093/burnst/tkz003.
[27]	谢春晖,高欣欣,孟祥龙,等.应用序贯激光治疗烧伤患儿早期增生性瘢痕的效果分析[J].中华烧伤杂志,2021,37(4):327-332.DOI: 10.3760/cma.j.cn501120-20201214-00526.
[28]	TanJ,ZhouJ,HuangL,et al.Hypertrophic scar improvement by early intervention with ablative fractional carbon dioxide laser treatment[J].Lasers Surg Med,2021,53(4):450-457.DOI: 10.1002/lsm.23301.
[29]	SongH,TanJ,FuQ,et al.Comparative efficacy of intralesional triamcinolone acetonide injection during early and static stage of pathological scarring[J].J Cosmet Dermatol,2019,18(3):874-878.DOI: 10.1111/jocd.12690.
[30]	吴军,唐丹,李曾慧平,等.烧伤康复治疗学[M].北京:人民卫生出版社,2015.
[31]	陆桂花,张建儿,林蔓婷. 积极护理元素综合干预法在烧伤后瘢痕瘙痒患者中的应用效果观察[J]. 中国医学创新,2020,17(13):94-98. DOI: 10.3969/j.issn.1674-4985.2020.13.023.
[32]	JafaryparvarZ,AdibM,GhanbariA,et al.Unplanned readmission after hospital discharge in burn patients in Iran[J].Eur J Trauma Emerg Surg,2019,45(2):365-371. DOI: 10.1007/S00068-018-0919-6.

Relative Articles

[1]	Tao Mingqiu, Huang Mitao, Liang Pengfei, Zhang Minghua, Zhang Pihong, He Zhiyou, Zeng Jizhang, Zhou Jie, Cui Xu, Guo Le, Zhou Situo, Yang Yan, Xie Tinghong, Huang Xiaoyuan. Methods and clinical effects of reconstructing facial and cervical scars with expanded flaps based on the "MLT" principle[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(7): 657-664. doi: 10.3760/cma.j.cn501225-20231215-00244
[2]	Zhang Wei, Zhang Weidong, Chen Lan, Luan Xiagang, Yang Fei, Li Ze, Liu Feng, Wang Deyun. Clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(9): 826-834. doi: 10.3760/cma.j.cn501225-20230706-00248
[3]	Bian Ruihao, Huang Shixin, Zhu Jiayuan, Wu Jun, Fan Kunwu, Hu Zhicheng, Xu Yingbin, Yu Qiuhua, Zhang Tao, Li Xueyi, Chen Shaozhen. Establishment of a topographic map assessment system for facial and cervical wounds and scars of burn patients based on the Delphi method[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(12): 1115-1121. doi: 10.3760/cma.j.cn501225-20230905-00075
[4]	Wang Zhantong, Dong Chen, Tang Yinke, Yu Zhou, Ma Xianjie. Clinical effect of pre-expanded deltopectoral flap in the repair of faciocervical lesion and defect[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(5): 363-369. doi: 10.3760/cma.j.cn501120-20200113-00019
[5]	Xia Chengde, Xue Jidong, Di Haiping, Cao Dayong, Han Dawei, Xie Jiangfan, Guo Haina, Xing Peipeng, Ma Xianjie. Clinical effects of single pedicle transfer of expanded axial flap across the midline of the frontal-parietal region in reconstruction of large scar deformities in the face and neck[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(9): 838-844. doi: 10.3760/cma.j.cn501120-20200311-00149
[6]	Yu Dongning, Shen Yuming, Chen Xin. Effect of axial flap of adjacent artery perforator with vascular pedicle in repairing facial and cervical scar deformity in patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(12): 848-854. doi: 10.3760/cma.j.issn.1009-2587.2019.12.004
[7]	Xie Weiguo, Lei Fang, Wang Juan, Xu Juan, Ruan Jingjing, Li Ze. Clinical effects of sequential laser treatments on early stage hypertrophic burn scars[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(9): 615-623. doi: 10.3760/cma.j.issn.1009-2587.2018.09.011
[8]	Zan Tao, Gao Yashan, Li Haizhou, Gu Bin, Xie Feng, Zhu Hainan, Li Qingfeng. Classification of massive postburn scars on neck and the reconstruction strategy using pre-expanded perforator flaps from the back[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2016, 32(8): 463-468. doi: 10.3760/cma.j.issn.1009-2587.2016.08.005
[9]	Tan Qian, Yan Xin. To improve the effect of reconstruction of scar contracture deformity on face and neck[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2016, 32(8): 456-457. doi: 10.3760/cma.j.issn.1009-2587.2016.08.003
[10]	Feng Shaoqing, Su Weijie, Xi Wenjing, Min Peiru, Pu Zheming, Zhang Yan, Zhang Yixin. Surgical strategy for postburn cervical scar contracture[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2015, 31(4): 280-284. doi: 10.3760/cma.j.issn.1009-2587.2015.04.012
[11]	ZHANG Qing-fu, ZHOU Hui-min, WANG Che-jiang, FENG Jian-ke, SHAO Hong-bo, BAI Yong-qiang, XU Shun-jiang, CUI Dong-sheng, YAN Bao-yong, LI Zeng-ning. Clinical effect of the concentrated suture fixation method on skin transplantation in the jaw and neck region[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2012, 28(4): 244-247. doi: 10.3760/cma.j.issn.1009-2587.2012.04.002
[14]	SHEN Yu-ming, HU Xiao-hua, WANG Hao, LI Ming, ZHANG Guo-an. Repair of cicatrical contracture in face and neck regions with expanded skin flap[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2009, 25(5): 357-359. doi: 10.3760/cma.j.issn.1009-2587.2009.05.010
[15]	CHENG Tian-min, RAN Xin-ze. Studies on the treatment of combined radiation-burn injury[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2008, 24(5): 387-389.
[16]	MA Xian-jie, XIA Wei, ZHENG Yan, XIA Wen-sen, LU Kai-hua, GUO Shu-zhong, HAN Yan, LU Bing-lun. Repair of facial and cervical scars with expanded dehopectoral flaps[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2008, 24(3): 207-209.
[17]	YANG Xing-hua, HUANG Xiao-yuan, XIAO Mu-zhang, ZENG Ji-zhang, LONG Jian-bong, FAN Peng-ju, ZHENG Jun. Repair of the scar in the midface by skin expansion with parallel juxtaposed skin expanders[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2006, 22(6): 431-433.
[19]	WANG Da-li, WANG Yu-ming, CHEN Shi-jiu, HAN Wen-jie, WEi Zai-rong, WANG Bo. The use of superficial cervical artery island skin flaps in the repair of the maxillofacial and cervical scar[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2005, 21(3): 196-198.
[20]	LI Yang-qun, TANG Yong, ZHOU Chuan-de, YANG Ming-yong, LI Sen-kai. Reconstruction of the mentum in the surgical management of cervical scar contracture[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2004, 20(6): 359-361.

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2) / Tables(3)

Get Citation

PDF

XML

Article Metrics

Article views (289) PDF downloads(39)

Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns

doi: 10.3760/cma.j.cn501120-20210323-00101

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns

doi: 10.3760/cma.j.cn501120-20210323-00101

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content