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羊膜在小儿面部浅度烧伤治疗中的应用

Amnion in the treatment of pediatric partial-thickness facial burns.

作者信息

Branski Ludwik K, Herndon David N, Celis Mario M, Norbury William B, Masters Oscar E, Jeschke Marc G

机构信息

Shriners Hospital for Children and University of Texas Medical Branch, 815 Market Street, Galveston, TX 77550, USA.

出版信息

Burns. 2008 May;34(3):393-9. doi: 10.1016/j.burns.2007.06.007. Epub 2007 Oct 24.

Abstract

BACKGROUND

Wound coverage for second-degree burns remains a clinical challenge. Human amniotic membranes have been used for many years in the treatment of burns; however, no large prospective clinical trials have been published. In this article, we present a novel and standardized procurement and processing method for amnion and investigate, whether the use of this biological dressing is safe and may represent a new therapeutic option for children with partial-thickness facial burns compared to standard topical treatment.

METHODS

Patients with partial-thickness burns of the face, neck and head admitted between 2003 and 2005 were included in this study. They were divided into two groups to receive either amnion (n=53) or topical antimicrobials (n=49). Demographics (age, gender, ethnicity, TBSA, burn areas), length of hospital stay (LOS), rate of infections (RI), time to total healing, and frequency of dressing changes were compared between the two groups. The long-term outcome was assessed in nine patients in the amnion group and eight patients in the topical group, who returned for up to 12-month follow-up visits.

RESULTS

Patients in the amnion group had significantly less dressing changes then in the control group (p<0.05). Time to healing, length of stay and the development of hypertrophic scarring was not different between the groups. Use of amnion was not associated with an increased risk of local infection.

CONCLUSION

This study indicates that amnion is safe and has advantages as wound coverage for second-degree facial burns compared to the standard topical ointments. Further studies with the use of amniotic membranes on the trunk and the extremities, as well as for coverage of grafted third-degree burns, have yet to be performed.

摘要

背景

二度烧伤的创面覆盖仍然是一项临床挑战。人羊膜已用于烧伤治疗多年;然而,尚无大型前瞻性临床试验发表。在本文中,我们提出了一种新颖且标准化的羊膜采集和处理方法,并研究这种生物敷料的使用是否安全,以及与标准局部治疗相比,它是否可能成为面部浅度烧伤儿童的一种新的治疗选择。

方法

纳入2003年至2005年间收治的面部、颈部和头部浅度烧伤患者。他们被分为两组,分别接受羊膜治疗(n = 53)或局部抗菌药物治疗(n = 49)。比较两组患者的人口统计学特征(年龄、性别、种族、总体表面积、烧伤面积)、住院时间(LOS)、感染率(RI)、完全愈合时间和换药频率。对羊膜组的9例患者和局部用药组的8例患者进行了长期随访,随访时间长达12个月。

结果

羊膜组患者的换药次数明显少于对照组(p<0.05)。两组之间的愈合时间、住院时间和增生性瘢痕的发生情况无差异。使用羊膜与局部感染风险增加无关。

结论

本研究表明,与标准局部软膏相比,羊膜用于二度面部烧伤的创面覆盖是安全的且具有优势。关于羊膜在躯干和四肢的应用以及用于覆盖三度烧伤植皮的进一步研究尚未开展。

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