序贯式护理在手足深度创面修复术后新生皮肤管理中的临床应用效果研究

Clinical Effect Study of Sequential Nursing in the Management of New Skin after Deep Burns to the Limbs

摘要: 目的：探讨序贯式护理在手足深度创面修复术后新生皮肤管理中的临床应用效果。方法：选取2024年1月至12月新疆医科大学第六附属医院收治的84例手足深度创面修复患者，按入院时间分为常规护理组(2024年1~6月，42例)和序贯护理组(2024年7~12月，42例)。常规组实施综合护理，包括皮肤清洁、润肤、抗瘢痕药物按摩及压力治疗等；序贯护理组在此基础上成立多学科团队，制定阶梯性护理计划并实施分段式康复护理评价。比较两组治疗前及治疗后1、3、12个月的温哥华瘢痕量表(VSS)评分、治疗有效率及不良反应发生率。结果：治疗前及治疗后1、3个月，两组VSS评分差异无统计学意义(P > 0.05)；治疗后12个月，序贯护理组VSS评分(5.05 ± 1.11)显著低于常规组(6.14 ± 1.27)，差异有统计学意义(P < 0.001)。序贯护理组治疗总有效率为92.86% (39/42)，显著高于常规组的71.43% (30/42) (P = 0.010)。序贯护理组不良反应发生率为2.38% (1/42)，低于常规组的19.05% (8/42) (P = 0.014)。结论：序贯式护理能显著改善四肢深度烧伤后新生皮肤的瘢痕状态，提高治疗有效率，降低不良反应风险，实现从创面愈合到功能康复的全程化管理，具有较高的临床推广价值。

Abstract: Objective: To evaluate the clinical effectiveness of sequential nursing in the management of neonatal skin after deep burns of the limbs. Methods: A total of 84 patients with deep limb burns admitted to the Sixth Affiliated Hospital of Xinjiang Medical University from January to December 2024 were enrolled. They were divided into a conventional nursing group (42 cases, admitted from January to June 2024) and a sequential nursing group (42 cases, admitted from July to December 2024). The conventional group received comprehensive nursing including skin cleaning, moisturizing, anti-scar massage with medication, and pressure therapy. On this basis, the sequential nursing group established a multidisciplinary team, developed a stepwise nursing plan, and implemented staged rehabilitation nursing evaluation. The Vancouver Scar Scale (VSS) scores before treatment and at 1, 3, and 12 months after treatment, treatment efficacy rates, and incidence of adverse reactions were compared between the two groups. Results: There were no significant differences in VSS scores between the two groups before treatment and at 1 and 3 months after treatment (P > 0.05). At 12 months after treatment, the VSS score in the sequential nursing group (5.05 ± 1.11) was significantly lower than that in the conventional group (6.14 ± 1.27) (P < 0.001). The total treatment efficacy rate in the sequential nursing group was 92.86% (39/42), significantly higher than that in the conventional group (71.43%, 30/42) (P = 0.010). The incidence of adverse reactions in the sequential nursing group was 2.38% (1/42), lower than that in the conventional group (19.05%, 8/42) (P = 0.014). Conclusion: Sequential nursing can significantly improve scar status, increase treatment efficacy, and reduce the risk of adverse reactions in the management of neonatal skin after deep limb burns, achieving whole-course management from wound healing to functional rehabilitation. It has high clinical application value.