Mak S S, Molassiotis A, Wan W M, Lee I Y, Chan E S
Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong.
Cancer Nurs. 2000 Jun;23(3):220-9. doi: 10.1097/00002820-200006000-00010.
The aim of the study was to compare the effect of a gentian violet topical application with that of a moist dressing (hydrocolloid) on the rate and efficacy of radiotherapy-induced moist desquamation wound healing and the patients' satisfaction level with each method. This prospective randomized clinical trial used a stratified sampling design. A sample of 39 patients with 60 wounds had their wounds assessed on alternate days in terms of several wound-healing parameters including wound size, wound pain, incidence of infection, and time required for healing. Patient satisfaction with each treatment was evaluated at the completion of the study. Gentian violet significantly decreased wound size and reduced wound pain. However, this treatment received significantly lower ratings for dressing comfort and dressing aesthetic acceptance. Nevertheless, the time required for healing was not statistically different in the two groups. These findings suggest that the lower score of dressing satisfaction level in the gentian violet group may result from the skin discoloration and drying effects of the treatment, which renders patients unable to move or stretch their skin. Although the aim is to have complete wound healing, this may not be realistic for many lesions such as radiotherapy-induced moist desquamation wounds. The best evidence on which to make decisions about individual care can now be based on patients' own perception of quality.
本研究的目的是比较龙胆紫局部应用与湿性敷料（水胶体）对放射治疗引起的湿性脱皮伤口愈合速度和疗效以及患者对每种方法满意度的影响。这项前瞻性随机临床试验采用分层抽样设计。对39例患者的60处伤口进行抽样，每隔一天根据包括伤口大小、伤口疼痛、感染发生率和愈合所需时间等几个伤口愈合参数对伤口进行评估。在研究结束时评估患者对每种治疗的满意度。龙胆紫显著减小了伤口大小并减轻了伤口疼痛。然而，这种治疗在敷料舒适度和敷料美观接受度方面的评分明显较低。尽管如此，两组的愈合所需时间在统计学上并无差异。这些发现表明，龙胆紫组敷料满意度得分较低可能是由于该治疗导致皮肤变色和干燥，使患者无法移动或伸展皮肤。尽管目标是实现伤口完全愈合，但对于许多如放射治疗引起的湿性脱皮伤口等病变来说，这可能并不现实。现在，关于个体护理决策的最佳依据可以基于患者自身对质量的感知。
