Delatte S J, Evans J, Hebra A, Adamson W, Othersen H B, Tagge E P
Division of Pediatric Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
J Pediatr Surg. 2001 Jan;36(1):113-8. doi: 10.1053/jpsu.2001.20024.
BACKGROUND/PURPOSE: Beta glucan collagen matrix (BGC), which combines the carbohydrate beta-glucan with collagen, has been used as a temporary coverage for adult partial thickness burns with reported good results. Observed advantages of BGC coverage include reduction of pain, improved healing, and better scar appearance. Potentially even more important in children is the elimination of painful daily dressing changes to the burned epithelial surface, as well as decreased fluid loss. This report details the authors' 2-year experience with BGC in a pediatric burn center.
Retrospective chart review of 225 consecutive pediatric patients treated at our institution between 1997 and 1999 identified 43 patients (19%) with suspected partial thickness burns treated with BGC as the primary wound dressing. BGC was applied to a debrided burn wound and secured with steri-strips, kerlix, and an ace wrap. After 24 hours, adherence of the BGC was confirmed and then left open to air.
The most common cause of burn injury was scald (61%), followed by flame (37%), and contact (2%). The average age of patients was 5.5 years (range, 6 weeks to 16 years) and mean percent total body surface area burned was 9.3% (1% to 35%). Thirty-four patients (79%) had the BGC remain intact while the wound healed underneath, with excellent cosmetic results, minimal analgesic requirements, and no need for repetitive dressing changes. Nine patients (21%) had the BGC removed before wound healing: 6 patients lost the BGC because of progression of the burn to full thickness, 2 had BGC nonadherence over a joint, and 1 had an unexplained nonadherence.
Partial-thickness burns in children can be effectively treated with BGC with good results, even in infants and toddlers. BGC markedly simplifies wound care for the patient and family and seems to significantly decrease postinjury pain.
背景/目的：β-葡聚糖胶原基质（BGC）将碳水化合物β-葡聚糖与胶原蛋白结合，已被用作成人浅Ⅱ度烧伤的临时覆盖物，报道显示效果良好。观察到的BGC覆盖的优点包括减轻疼痛、促进愈合以及改善瘢痕外观。在儿童中，可能更重要的是消除了对烧伤上皮表面进行每日痛苦的换药，以及减少了液体流失。本报告详细介绍了作者在一家儿科烧伤中心使用BGC的两年经验。
对1997年至1999年在我们机构接受治疗的225例连续儿科患者进行回顾性病历审查，确定43例（19%）疑似浅Ⅱ度烧伤患者以BGC作为主要伤口敷料进行治疗。将BGC应用于清创后的烧伤伤口，并用无菌胶带、纱布绷带和弹力绷带固定。24小时后，确认BGC的粘附情况，然后让其暴露于空气中。
烧伤最常见的原因是烫伤（61%），其次是火焰烧伤（37%）和接触烧伤（2%）。患者的平均年龄为5.5岁（范围为6周至16岁），平均烧伤总面积百分比为9.3%（1%至35%）。34例（79%）患者的BGC在伤口在其下方愈合时保持完整，美容效果极佳，镇痛需求 minimal，且无需重复换药。9例（21%）患者在伤口愈合前移除了BGC：6例患者因烧伤进展为全层而失去BGC，2例患者在关节处BGC未粘附，1例患者出现不明原因的未粘附。
儿童浅Ⅱ度烧伤可用BGC有效治疗，效果良好，即使在婴幼儿中也是如此。BGC显著简化了患者和家庭的伤口护理，似乎能显著减轻伤后疼痛。
