Harte Daniel, Gordon Jude, Shaw Maxine, Stinson May, Porter-Armstrong Alison
Royal Hospitals Trust, Belfast, Northern Ireland.
J Burn Care Res. 2009 Jul-Aug;30(4):632-42. doi: 10.1097/BCR.0b013e3181ac01a3.
This pilot study investigates whether pressure and silicone therapy used simultaneously are more effective in treating multiple characteristics of hypertrophic scars than pressure alone. A pilot randomized controlled trial was conducted. Twenty-two participants with hypertrophic burn scars were randomized to receive Jobskin pressure garments and Mepiform silicone sheeting or Jobskin pressure garments alone. The Vancouver Scar Scale (VSS) was used to measure multiple scar characteristics at baseline, week 12, and week 24. No statistically significant difference was found in the rate of change of the VSS scores between the pressure therapy (PT) group and the pressure therapy and silicone group at week 12 or week 24; however, the mean scores of both groups reduced over 24 weeks. There were no statistically significant changes in the VSS subscores (scar height, vascularity, pliability, and pigmentation) from baseline to week 12 or week 24. A statistically significant relationship was observed between the VSS score and TBSA burned (<30%) in the PT group at baseline (P<.05), over 12 weeks (P<.05), and over 24 weeks (P<.05). Given the limitations of this study, especially the small sample size, further research is necessary before any firm conclusions can be drawn on this therapy approach. However, this pilot study has discussed the recurring issues in the research regarding these controversial treatments and has yielded potential for further investigation in a fully powered randomized controlled trial.
这项初步研究调查了同时使用压力疗法和硅胶疗法治疗增生性瘢痕的多种特征是否比单独使用压力疗法更有效。进行了一项初步随机对照试验。22名患有增生性烧伤瘢痕的参与者被随机分为两组，一组接受Jobskin压力衣和美皮护硅胶片治疗，另一组仅接受Jobskin压力衣治疗。使用温哥华瘢痕量表（VSS）在基线、第12周和第24周测量多种瘢痕特征。在第12周或第24周时，压力疗法（PT）组与压力疗法加硅胶组之间的VSS评分变化率没有统计学上的显著差异；然而，两组的平均评分在24周内均有所降低。从基线到第12周或第24周，VSS子评分（瘢痕高度、血管分布、柔韧性和色素沉着）没有统计学上的显著变化。在基线时（P<0.05）、12周时（P<0.05）和24周时（P<0.05），PT组的VSS评分与烧伤总面积（<30%）之间存在统计学上的显著关系。鉴于本研究的局限性，尤其是样本量小，在就这种治疗方法得出任何确凿结论之前，有必要进行进一步的研究。然而，这项初步研究讨论了关于这些有争议治疗方法的研究中反复出现的问题，并为在一项充分有力的随机对照试验中进行进一步调查提供了可能性。
