摘要目的　为探讨深二度烧伤创面坏死组织持续存在对创面组织进行性损害的影响。方法　将7例施行削痂手术的深Ⅱ度烧伤患者创面分为手术前、手术后、和坏死组织存在的未手术创面，并分别获取创面组织标本，测定创面组织释放IL－8、EGF、bFGF、PDGF-AB水平以及观察组织形态学变化。结果　7例未手术创面组织在体外组织培养中释放IL-8水平较削痂手术后创面水平有明显升高（P<0.001）；同时,未手术创面EGF、bFGF、PDGF-AB水平与其配对的削痂手术后创面比较均呈明显降低（P<0.05-<0.005）。局部组织形态学观察亦显示，坏死组织存在的未手术创面除有大量中性粒细胞浸润外，坏死范围较手术前扩大，残留的少量皮肤附件因炎症扩大而消失，而削痂后创面的炎性反应较未手术和手术前有明显减轻，无坏死范围的进一步扩大，甚至可见新生肉芽形成和部分表皮修复。结论　创面坏死组织持续存在不仅是创面愈合过程的抑制因素，而且还可能因炎症反应加强或持续存在而导致创面进一步加深，使创面愈合更为延迟。削痂手术作为一种去除坏死组织的主动手段，对促进创面愈合有积极意义。

abstractsObjective To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds.Methods Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn.Results In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P<0.001), while the levels of EGF, bFGF, PDGF-AB release were lower than those in the post-operation group. Histopathological examination revealed that in the non-operation group, the degree of neutrophil infiltration was enhanced, the extent of tissue necrosis enlarged, and residual skin appendages disappeared. In contrast, in the post-operation group, the degree of inflammatory response was decreased, with the formation of fresh granulation tissue and epithelialization.Conclusion This study suggests that the presence of necrotic tissue could be the inhibitory factor in the wound healing process, as it might cause tissue progressive injury leading to the delay of wound healing. To promote wound healing, active tangential excision is recommended to remove necrotic tissue.