Objective To investigate the relationship between early eschar grinding and infection in the patients with large area of deep partial thickness burns. Methods Prospective studies were conducted in 35 patients with more than 30% TBSA of deep partial thickness burns. The patients were divided into eschar grinding group (EG group) and conservative care group (CC group) according to the different treatments regimes. The burn wounds of 17 patients in CC group were treated with 0.2% bromogeramine solution and 1% sulfadiazine silver cream,and changed dressings everyday. The 18 patients in EG group were treated with dermabrasion under general anesthesia within 48 hours after admission. The occurrence of systemic inflammatory response syndrome (SIRS) and sepsis,development of serum lipopolysaccharide (LPS),TNF-α,IL-6,and IL-8 were compared between the two groups. Results The patients in EG group were healed averagely within 14.1 days,while those in CC group within 19.8 days. The incidence rate of SIRS and sepsis in EG group was 31%,lower than that of CC group(85%). The serum levels of LPS, IL-6 and IL-8 of EG group were also lower than CC group. Conclusion Early eschar grinding of large area deep partial thickness burns under general anesthesia not only can shortenwound healing time but avoid burn wound and systemic infection.%目的：研究早期大面积深Ⅱ度烧伤磨痂与烧伤感染的关系。方法对35例烧伤面积＞30％且创面以深Ⅱ度烧伤为主的烧伤患者，进行前瞻性研究。按对创面处理的方式不同，将其分为早期磨痂组和保痂组。保痂组17例，用苯扎溴铵简单清创，创面用磺胺嘧啶银乳膏包扎处理，并上悬浮床或翻身床，换药治疗。早期磨痂组18例，休克纠正后，48 h内在全麻下行磨痂术，用钢丝球磨除创面的坏死组织，刚好有小出血点为止，创面冲洗后，再用术尔泰纱布湿敷，最后将生物敷料（脱细胞猪皮）覆盖创面，外层用纳米银纱布加压包扎。比较两组患者全身炎症反应综合征及脓毒症发生率，以及内毒素（LPS）、TNF-α、IL-6、IL-8的动态变化。结果早期磨痂组，磨痂时间在伤后48 h以内，磨痂面积30％～60％，平均愈合时间为14．1 d，保痂组平均愈合间为19．8 d；磨痂组全身炎症反应综合征及脓毒发生率为31％，低于保痂组的85％。 LPS、IL-6、IL-8同时低于保痂组。结论大面积深Ⅱ度烧伤早期全麻下磨痂，不仅能缩短创面愈合时间，而且降低创面感染及全身感染。
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