Innes M E, Umraw N, Fish J S, Gomez M, Cartotto R C
The Ross Tilley Burn Center, Sunnybrook and Women's College Health Sciences Center, 2075 Bayview Ave., Ont., M4N 3M5, Toronto, Canada.
Burns. 2001 Sep;27(6):621-7. doi: 10.1016/s0305-4179(01)00015-8.
Acticoat, a new silver-coated dressing, produces a moist healing environment along with the sustained release of ionic silver for improved microbial control. These properties suggest that Acticoat might be a useful donor site dressing. However, there are no human studies which assess Acticoat for this use. The purpose of this study was to compare the healing of human skin graft donor sites dressed with Acticoat, to the healing of those dressed with Allevyn, an occlusive moist-healing environment material, which is our standard donor site dressing. In burn patients who had undergone burn excision and grafting, identical side-by-side split thickness donor site wound pairs were dressed with Allevyn and Acticoat. Re-epithelialization was directly assessed daily by a single observer from post-operative day 6 onward, and by four independent observers who rated the extent of re-epithelialization by viewing standardized digital images of the wounds that had been obtained on post-operative days 6, 8, 10,and 12. Donor sites were swabbed for bacterial culture on days 3, 6, and 9. Subsequently, each study donor site scar was rated by a blinded observer using the Vancouver Scar Scale at 1, 2, and 3 months. Sixteen paired sites in 15 patients (3 female, 12 male) were studied. Donor sites dressed with Allevyn were >90% re-epithelialized at a mean of 9.1+/-1.6 days while donor sites dressed with Acticoat required a mean of 14.5+/-6.7 days to achieve >90% re-epithelialization (P=0.004). The Allevyn sites had significantly greater estimated re-epithelialization at days 6, 8, 10 and 12 than the Acticoat sites based on the observations of the digital images. There were no significant differences in the incidence of positive bacterial cultures with either dressing at days 3, 6, and 9. Donor sites dressed with Acticoat had significantly worse scars at 1 and 2 months but this difference resolved by 3 months. Our findings do not support the use of Acticoat as a skin graft donor site dressing.
Acticoat是一种新型的镀银敷料，能营造湿润的愈合环境，并持续释放离子银以更好地控制微生物。这些特性表明Acticoat可能是一种有用的供皮区敷料。然而，尚无针对此用途评估Acticoat的人体研究。本研究的目的是比较用Acticoat包扎的人体皮肤移植供皮区的愈合情况与用Allevyn（一种封闭性湿润愈合环境材料，是我们标准的供皮区敷料）包扎的供皮区的愈合情况。在接受烧伤切除和植皮手术的烧伤患者中，将相同的并排的中厚供皮区伤口对分别用Allevyn和Acticoat包扎。从术后第6天起，由一名观察者每天直接评估再上皮化情况，术后第6、8、10和12天，由四名独立观察者通过查看伤口的标准化数字图像来评估再上皮化的程度。在第3、6和9天对供皮区进行拭子细菌培养。随后，由一名不知情的观察者在1、2和3个月时使用温哥华瘢痕量表对每个研究供皮区的瘢痕进行评分。对15例患者（3例女性，12例男性）的16对供皮区进行了研究。用Allevyn包扎的供皮区平均在9.1±1.6天实现>90%再上皮化，而用Acticoat包扎的供皮区平均需要14.5±6.7天才能实现>90%再上皮化（P = 0.004）。根据数字图像观察，在术后第6、8、10和12天，Allevyn组供皮区的预计再上皮化程度明显高于Acticoat组。在第3、6和9天，两种敷料的细菌培养阳性发生率无显著差异。用Acticoat包扎的供皮区在1个月和2个月时瘢痕明显更差，但这种差异在3个月时消失。我们的研究结果不支持将Acticoat用作皮肤移植供皮区敷料。
