Gravante Gianpiero, Montone Antonio
Department of Surgery, Whipps Cross University Hospital, London, UK.
Ann R Coll Surg Engl. 2010 Mar;92(2):118-23. doi: 10.1308/003588410X12518836439001. Epub 2009 Dec 7.
In this study, we retrospectively analysed healing times of ambulatory burn patients after silver-based dressings were introduced in late December 2005, and compared the results with those obtained before.
Data were collected in November-December 2005 and in January-February 2006. We excluded from the study: (i) admitted patients; (ii) patients with mixed superficial partial thickness and deep partial thickness burns; (iii) patients with full-thickness burns; and (iv) operated patients that came for follow-up. We recorded the age, sex, cause (flame vs scald), burn depth, dressings used and healing times.
We selected 347 patients corresponding to 455 burned areas (64.4% superficial and 35.6% deep; 47.7% treated in 2005 and 52.3% in 2006). During the years 2005 and 2006, there was an increase in the use of silver-based dressings (2005, 9.7%; 2006, 38.7%; chi-squared test, P < 0.001) and a decrease in the use of paraffin gauzes (2005, 66.4%; 2006, 40.3%; chi-squared test, P < 0.001). The healing time of overall burns and of superficial burns showed no significant differences between 2005 and 2006. However, in deep partial thickness burns, a significant reduction was present (2006, 19; 2005, 29 days; Student's t-test, P < 0.01). Among all dressings, paraffin gauzes had the shortest healing times in superficial burns (5 days); with silver-based dressings in deep burns, the healing times were nanocrystalline silver (16 days) and silver carboxymethylcellulose (21 days).
Results of our retrospective study would suggest that paraffin gauzes are a valuable option in superficial burns, while silver-based dressings are preferable in deep burns.
在本研究中,我们回顾性分析了2005年12月底引入银基敷料后门诊烧伤患者的愈合时间,并将结果与之前获得的结果进行比较。
数据收集于2005年11月至12月以及2006年1月至2月。我们将以下患者排除在研究之外:(i)住院患者;(ii)浅Ⅱ度和深Ⅱ度混合烧伤患者;(iii)全层烧伤患者;(iv)前来随访的手术患者。我们记录了年龄、性别、病因(火焰伤与烫伤)、烧伤深度、使用的敷料及愈合时间。
我们选取了347例患者,对应455个烧伤部位(浅Ⅱ度占64.4%,深Ⅱ度占35.6%;2005年治疗的占47.7%,2006年治疗的占52.3%)。在2005年和2006年期间,银基敷料的使用有所增加(2005年为9.7%,2006年为38.7%;卡方检验,P<0.001),而石蜡纱布的使用有所减少(2005年为66.4%,2006年为40.3%;卡方检验,P<0.001)。2005年和2006年总体烧伤和浅Ⅱ度烧伤的愈合时间无显著差异。然而,在深Ⅱ度烧伤中,愈合时间有显著缩短(2006年为19天,2005年为29天;学生t检验,P<0.01)。在所有敷料中,石蜡纱布在浅Ⅱ度烧伤中的愈合时间最短(5天);在深Ⅱ度烧伤中,银基敷料中纳米晶银的愈合时间为16天,羧甲基纤维素银为21天。
我们的回顾性研究结果表明,石蜡纱布在浅Ⅱ度烧伤中是一种有价值的选择,而银基敷料在深Ⅱ度烧伤中更可取。