Association of Dutch Burn Centres, Beverwijk, The Netherlands.
Burns. 2012 Feb;38(1):19-25. doi: 10.1016/j.burns.2011.06.003. Epub 2011 Aug 9.
Static splinting therapy is widely considered an essential part in burn rehabilitation to prevent scar contractures in the early phase of wound healing. However, scar contractures are still a common complication. In this article we review the information concerning the incidence of scar contracture, the effectiveness of static splinting therapy in preventing scar contractures, and specifically focus on the - possible - working mechanism of static-splinting, i.e. mechanical load, at the cellular and molecular level of the healing burn wound.
A literature search was done including Pubmed, Cochrane library, CINAHL and PEDRO.
Incidence of scar contracture in patients with burns varied from 5% to 40%. No strong evidence for the effectiveness of static splinting therapy in preventing scar contracture was found, whereas in vitro and animal studies demonstrated that mechanical tension will stimulate the myofibroblast activity, resulting in the synthesis of new extracellular matrix and the maintenance of their contractile activity.
The effect of mechanical tension on the wound healing process suggests that static splinting therapy may counteract its own purpose. This review stresses the need for randomised controlled clinical trials to establish if static splinting to prevent contractures is a well-considered intervention or just wishful thinking.
在烧伤康复早期，静态夹板疗法被广泛认为是预防瘢痕挛缩的重要手段。然而，瘢痕挛缩仍然是一种常见的并发症。本文综述了有关瘢痕挛缩发生率、静态夹板疗法预防瘢痕挛缩的有效性，以及特别关注静态夹板可能的工作机制，即在愈合烧伤创面的细胞和分子水平上的机械负荷。
检索了 Pubmed、Cochrane 图书馆、CINAHL 和 PEDRO 数据库。
烧伤患者的瘢痕挛缩发生率为 5%至 40%。没有强有力的证据表明静态夹板疗法在预防瘢痕挛缩方面的有效性，而体外和动物研究表明，机械张力会刺激肌成纤维细胞的活性，导致新的细胞外基质的合成和其收缩活性的维持。
机械张力对伤口愈合过程的影响表明，静态夹板疗法可能会适得其反。这篇综述强调了需要进行随机对照临床试验，以确定预防挛缩的静态夹板疗法是否是一种经过深思熟虑的干预措施，还是仅仅是一厢情愿。
