Muangman Pornprom, Nitimonton Sooksan, Aramwit Pornanong
Burn Unit, Trauma Division, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; E-Mails:
Int J Mol Sci. 2011;12(8):5031-8. doi: 10.3390/ijms12085031. Epub 2011 Aug 8.
The Bactigras(®) paraffin tulle coated with chlorhexidine is normally used for the treatment of donor-site wounds in burn patients who received split-thickness skin grafts in several centers. It has some disadvantages, such as adhesion to wound surfaces and pain from the irritation caused by this dressing. The Telfa AMD(®), a non-adherent wound dressing which consists of absorbent cotton fibers impregnated with polyhexamethylene biguanide enclosed in a sleeve of thermoplastic polymers, is a new option for donor-site wound care which causes less adherence to the wound. The purpose of this study was to compare clinical efficacy of these two dressings for the management of donor-site wounds. Thirty-two patients who received split-thickness skin grafts by donor site harvesting from the thigh were enrolled in this study and randomized into two groups receiving either the Bactigras(®) or the Telfa AMD(®) wound treatment. Re-epithelialization, pain, infection and cost-effectiveness analyses were compared between both groups. The results showed that there was no significant difference in age, area of donor sites or length of hospital stays between the groups (p > 0.05). However, the day of re-epithelialization (≥90%) was significantly shorter in patients treated with the Telfa AMD(®) compared to the Bactigras(®) group (14.00 ± 3.05 vs. 9.25 ± 1.88 days for Bactigras(®) and Telfa AMD(®) groups, respectively, p < 0.001). The average pain score was also significantly lower in the Telfa AMD(®) group (1.57 ± 0.55 vs. 4.70 ± 1.16, p < 0.001). There was no difference in the cost of treatment between the groups (4.64 ± 1.97 vs. 5.72 ± 2.54 USD, p = 0.19). This study indicated that the Telfa AMD(®) was an effective dressing for the treatment of donor-site wounds.
在多个中心，接受了中厚皮片移植的烧伤患者的供皮区伤口通常使用涂有氯己定的Bactigras（®）石蜡纱布进行治疗。它存在一些缺点，比如会黏附在伤口表面，且这种敷料引起的刺激会导致疼痛。Telfa AMD（®）是一种非黏附性伤口敷料，由浸渍有聚六亚甲基双胍的吸水棉纤维包裹在热塑性聚合物套管中组成，是供皮区伤口护理的一种新选择，对伤口的黏附性较小。本研究的目的是比较这两种敷料对供皮区伤口处理的临床疗效。32例通过从大腿取皮进行中厚皮片移植的患者纳入本研究，并随机分为两组，分别接受Bactigras（®）或Telfa AMD（®）伤口治疗。比较两组之间的再上皮化、疼痛、感染情况及成本效益分析。结果显示，两组之间在年龄、供皮区面积或住院时间方面无显著差异（p>0.05）。然而，与Bactigras（®）组相比，接受Telfa AMD（®）治疗的患者再上皮化（≥90%）的天数明显更短（Bactigras（®）组和Telfa AMD（®）组分别为14.00±3.05天和9.25±1.88天，p<0.001）。Telfa AMD（®）组的平均疼痛评分也显著更低（1.57±0.55 vs. 4.70±1.16，p<0.001）。两组之间的治疗费用无差异（4.64±1.97美元 vs. 5.72±2.54美元，p = 0.19）。本研究表明，Telfa AMD（®）是治疗供皮区伤口的一种有效敷料。
