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水胶体银敷料在处理供皮区的应用:两种护理方案的随机评估。

Hydrofiber dressing with silver for the management of split-thickness donor sites: a randomized evaluation of two protocols of care.

机构信息

Lehigh Valley Hospital, Regional Burn Center, Allentown, PA 18103-6218, USA.

出版信息

Burns. 2010 Aug;36(5):665-72. doi: 10.1016/j.burns.2009.06.193. Epub 2009 Dec 6.

Abstract

BACKGROUND

This randomized, open-label study evaluated Aquacel Ag Hydrofiber dressing with silver (HDS; ConvaTec, Skillman, NJ, USA) with an adherent or gelled protocol in the management of split-thickness donor sites.

METHODS

HDS was the primary dressing in the adherent group (gauze as secondary covering) and gelled group (transparent film as secondary covering). Dressings were changed on study day 1 or 2 and study days 5 (optional), 10 (optional), and 14. The primary outcome was healing (>or=90% re-epithelialization) at study day 14.

RESULTS

Seventy subjects were treated (36 adherent, 34 gelled). By study day 14, 77% of donor sites had healed (67% adherent, 88% gelled). Pain scores decreased over time in both treatment groups. Investigators were "very satisfied" or "satisfied" with (adherent, gelled) time required to manage dressing change (89%, 79% of subjects), minimization of donor-site pain (64%, 82%), ease of application (97%, 94%), management of drainage (92%, 82%), ease of removal (77%, 85%), and ability of dressing to remain in place (69%, 76%). Thirty-nine (56%) subjects had adverse events, most commonly non-donor-site infection (11%) and gastrointestinal events (11%).

CONCLUSION

In this randomized, open-label study, HDS was well-tolerated, versatile, and effective in the management of split-thickness donor sites.

摘要

背景

本随机、开放性研究评估了水胶体银抗菌敷料(HDS;康维德,新泽西州斯凯勒姆,美国)在处理刃厚皮片供皮区时采用黏附或凝胶化方案的效果。

方法

HDS 是黏附组(纱布作为二级覆盖物)和凝胶组(透明薄膜作为二级覆盖物)的主要敷料。在研究第 1 天或第 2 天和第 5 天(可选)、第 10 天(可选)和第 14 天更换敷料。主要结局指标是研究第 14 天时愈合(>90%再上皮化)。

结果

70 例患者接受了治疗(黏附组 36 例,凝胶组 34 例)。研究第 14 天,77%的供皮区已愈合(黏附组 67%,凝胶组 88%)。两组患者的疼痛评分随时间逐渐降低。研究人员对处理敷料更换所需的时间(黏附组 89%,凝胶组 79%的患者)、最大限度减少供皮区疼痛(黏附组 64%,凝胶组 82%)、易于应用(黏附组 97%,凝胶组 94%)、引流管理(黏附组 92%,凝胶组 82%)、易于去除(黏附组 77%,凝胶组 85%)和敷料保持原位的能力(黏附组 69%,凝胶组 76%)表示“非常满意”或“满意”。39 例(56%)患者出现不良事件,最常见的是非供皮区感染(11%)和胃肠道事件(11%)。

结论

在这项随机、开放性研究中,HDS 耐受性良好、用途广泛且在处理刃厚皮片供皮区时效果显著。

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