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急性浅度烧伤手部的处理;湿润烧伤膏或磺胺嘧啶银乳膏联合聚乙烯袋治疗

Management of the Acute Partial-thickness Burned Hand; Moist Exposed Burn Ointment or Silver Sulphadiazine Cream both Combined with a Polyethylene Bag.

作者信息

Allam A M, Mostafa W, Zayed E, El-Gamaly J

机构信息

Department of General Surgery, Plastic and Reconstructive Unit, Faculty of Medicine, Tanta University, Egypt.

出版信息

Ann Burns Fire Disasters. 2007 Sep 30;20(3):144-8.

Abstract

Hand burns predominantly affect young adults, and therefore have serious social and financial implications. In the present work, 106 patients with less than 25% body surface area burns and acute partial-thickness burned hands were managed using polyethylene bags and 1% local silver sulphadiazine (SSD) cream or moist exposed burn ointment (MEBO). Females made up 61.3% of the cases and flame burn was the majority cause (54.7%). There were no significant differences between the two groups regarding either the analgesic effect after local ointment application or hand movement inside the polyethylene bag. Local agent crustation over the wound was very evident in the hands managed by local 1% SSD cream (69.81%). On follow-up, the burned hands healed faster using local MEBO (10.48 versus 14.53 days), with fewer post-burn hand deformities and better active hand movements; however, the total cost until complete hand burn wound healing was higher with MEBO than with 1% SSD, although the final results were superior, with early return to work, when MEBO was used. We concluded that the use of MEBO as a topical agent and of polyethylene bags for the dressing of the acute partial-thickness burned hand accelerated healing; daily wound evaluation was easy as there was no crustation over it of the agent. It was more expensive than 1% SSD cream but presented fewer post-burn complications and more rapid healing, with shorter hospital stay.

摘要

手部烧伤主要影响年轻人,因此具有严重的社会和经济影响。在本研究中,对106例烧伤面积小于25%且手部为急性浅度烧伤的患者,采用聚乙烯袋并联合1%磺胺嘧啶银(SSD)乳膏或湿润烧伤膏(MEBO)进行治疗。女性占病例总数的61.3%,火焰烧伤是主要原因(54.7%)。两组在局部涂抹药膏后的镇痛效果或聚乙烯袋内手部活动方面均无显著差异。在使用1% SSD乳膏治疗的手部,伤口处局部药物结痂非常明显(69.81%)。随访结果显示,使用局部MEBO治疗的烧伤手部愈合更快(10.48天对14.53天),烧伤后手部畸形更少,手部主动活动更好;然而,MEBO治疗直至手部烧伤伤口完全愈合的总费用高于1% SSD,尽管最终结果更优,使用MEBO时患者能更早重返工作岗位。我们得出结论,使用MEBO作为局部用药并采用聚乙烯袋包扎急性浅度烧伤的手部可加速愈合;由于伤口上没有药物结痂,每日伤口评估很容易。它比1% SSD乳膏更昂贵,但烧伤后并发症更少,愈合更快,住院时间更短。

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