Vermeulen H, Ubbink D T, Goossens A, de Vos R, Legemate D A
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Br J Surg. 2005 Jun;92(6):665-72. doi: 10.1002/bjs.5055.
The best dressing for postoperative wounds healing by secondary intention is unknown.
A systematic review was conducted to assess the effectiveness of dressings and topical agents on such wounds. Main endpoints were wound healing, pain, patient satisfaction, costs and hospital stay. Systematic methodological appraisal and data extraction were performed by independent reviewers.
Fourteen reports of 13 randomized clinical trials on dressings or topical agents (gauze, foam, bead, alginate and hydrocolloid dressing) for postoperative wounds healing by secondary intention were identified; they were of weak methodological quality. In general, no statistically significant differences in wound healing were found for various dressing comparisons (11 of 13 trials). Patients experienced significantly more pain (four of six trials) and were less satisfied when gauze was used (three of six trials). Gauze was inexpensive, but its use was associated with significantly more nursing time than dressing with foam (two of three trials). No substantial differences in hospital stay were found (four of five trials).
Only small, poor-quality trials exist, rendering the evidence insufficient. Foam is best studied as an alternative to gauze and appears to be preferable in terms of pain reduction, patient satisfaction and nursing time.
二期愈合术后伤口的最佳敷料尚不明确。
进行一项系统评价以评估敷料和外用制剂对此类伤口的有效性。主要终点为伤口愈合、疼痛、患者满意度、成本和住院时间。由独立评审员进行系统的方法学评价和数据提取。
共识别出13项关于敷料或外用制剂（纱布、泡沫、珠子、藻酸盐和水胶体敷料）用于二期愈合术后伤口的随机临床试验的14份报告；其方法学质量较弱。总体而言，各种敷料比较在伤口愈合方面未发现统计学显著差异（13项试验中的11项）。使用纱布时患者疼痛更明显（6项试验中的4项），满意度更低（6项试验中的3项）。纱布价格便宜，但与使用泡沫敷料相比，使用纱布的护理时间显著更长（3项试验中的2项）。住院时间未发现实质性差异（5项试验中的4项）。
仅存在小型、质量差的试验，证据不足。作为纱布的替代品，泡沫敷料研究得最多，在减轻疼痛、患者满意度和护理时间方面似乎更具优势。
