Terrill P J, Goh R C W, Bailey M J
Department of Surgery, Monash University, Melbourne, Australia.
J Wound Care. 2007 Nov;16(10):433-8. doi: 10.12968/jowc.2007.16.10.27912.
To identify the optimal dressing for split-thickness skin graft (SSG) donor sites.
This prospective randomised controlled trial compared two dressings - a new absorbent form of a polyurethane film dressing (Tegaderm Absorbent, 3M) and our standard alginate dressing (Kaltostat, ConvaTec) - on SSG donor sites in 40 patients. Primary outcome measures were: reduced time to full healing; reduced postoperative pain; reduced leakage rates from the dressing. Secondary outcome measures related to acceptability of the dressings to the patient.
On removal of the dressings at the first assessment, 79% of the Tegaderm Absorbent donor sites had healed completely, compared with 16% of the Kaltostat ones (p<0.001).A significantly greater median area had healed with Tegaderm Absorbent (100%), when compared with Kaltostat (89%) (p<0.001). Mean time to complete healing was also significantly faster for Tegaderm Absorbent than Kaltostat (14 versus 21 days) (p<0.001). Significantly fewer subjects experienced postoperative pain with Tegaderm Absorbent on both day 1 (21% versus 67%, p=0.006, NNT=3) and day 2 (17% versus 75%, p<0.001, NNT=2). Leakage rates reduced by 48% with Tegaderm Absorbent, with no leakage in the smaller donor sites. Tegaderm Absorbent was significantly easier to apply than Kaltostat (89% versus 27% found it'very easy') as was ease of removal (84% versus 11% found it'very easy') (p<0.0001). Patients found Tegaderm Absorbent dressings significantly more convenient to manage and bathe with. At one month post-surgery, Vancouver scar scores showed thatTegaderm Absorbent donor sites were less red, flatter, softer and less itchy.
Tegaderm Absorbent provides a significant improvement in terms of donor-site pain, healing and ease of management.
确定用于中厚皮片（SSG）供皮区的最佳敷料。
这项前瞻性随机对照试验在40例患者的SSG供皮区比较了两种敷料——一种新型聚氨酯薄膜吸收性敷料（泰德思吸收型，3M公司）和我们的标准藻酸盐敷料（卡托斯塔，康维德公司）。主要结局指标为：缩短完全愈合时间；减轻术后疼痛；降低敷料渗漏率。次要结局指标与患者对敷料的可接受性有关。
在首次评估时去除敷料时，79%的泰德思吸收型供皮区已完全愈合，而卡托斯塔供皮区的这一比例为16%（p<0.001）。与卡托斯塔（89%）相比，泰德思吸收型敷料愈合的中位面积显著更大（100%）（p<0.001）。泰德思吸收型敷料完全愈合的平均时间也显著快于卡托斯塔（分别为14天和21天）（p<0.001）。在第1天（21%对67%，p=0.006，需治疗人数=NNT=3）和第2天（17%对75%，p<0.001，NNT=2），使用泰德思吸收型敷料术后疼痛的受试者明显更少。泰德思吸收型敷料的渗漏率降低了48%，较小的供皮区无渗漏。泰德思吸收型敷料比卡托斯塔敷料明显更容易应用（89%对27%认为“非常容易”），去除也更容易（84%对11%认为“非常容易”）（p<0.0001）。患者发现泰德思吸收型敷料在管理和沐浴方面明显更方便。术后1个月，温哥华瘢痕评分显示，泰德思吸收型供皮区颜色更淡、更平整、更柔软且瘙痒更少。
泰德思吸收型敷料在供皮区疼痛、愈合及管理便利性方面有显著改善。
