目的 研究银离子敷料联合水胶体密闭法促进难愈性深度烧伤创面愈合的作用。方法 选择2010-04至2012-04 我院烧伤科住院的难愈性深度烧伤患者64例作为观察对象。根据患者自愿原则分为2组：治疗组应用银离子敷料联合水胶体密闭法序贯换药；对照组采用湿碘伏（浓度为0.5%）纱布、凡士林纱布、棉垫逐层外敷。在切痂、削痂或扩创后1、5、10、15、20、25 d 进行创面分泌物细菌培养，观察记录创面肉芽生长情况及速度，观察药物不良反应、换药时创面痛感。结果 治疗组创面细菌检出率明显低于对照组(P＜0.05)。治疗组新鲜肉芽生长时间比对照组平均缩短7～8 d。治疗组新鲜肉芽生长速度较对照组明显加快(P＜ 0.05)。两组均无药物不良反应，治疗组创面换药时无明显疼痛感。结论 银离子敷料联合水胶体密闭法序贯治疗难愈性深度烧伤创面具有显著抗菌及促进创面肉芽组织和上皮再生，促进创面愈合的作用，且无不良反应。

Objective To study the efficacy of ionic silver dressing combined with hydrogel in promoting refractory burn wound healing. Methods A total of 64 patients with refractory deep burn were recruited from the Department of Burn, Chengdu Hospital of Armed Police Forces, between April 2010 and April 2012. These patients were randomly divided into observation group (ionic silver dressing combined with hydrogel were used) and control group (wet povidone iodine at the concentration of 0.5 %, gauze, vaseline gauze, and the cotton pad layer were used). Secretions from the wound underwent bacterial culture at day 1, 5, 10, 15 and 25 after the excision of eschar or after debridement to record the healing condition and velocity while observing adverse reactions, wound painfulness, and granulation damage. Results The detection rate of wound bacteria in the observation group was significantly lower than that in the control group (P＜ 0.05). Fresh granulation growth time in the observation group was 7.0-8.0 days shorter than that in the control group. Fresh granulation grew significantly faster in the observation group than in the control group (P＜ 0.05). There were no adverse reactions in either group. Additionally, the observation group suffered no significant pain and no significant damage to granulation tissue during wound dressing. Conclusions The ionic silver dressing combined with hydrogel remarkably promotes regeneration of granulation tissue and epithelial cells while accelerating wound healing, without any adverse effect on the refractory burn wound healing.