Danino A M, Guberman S, Mondié J-M, Jebrane A, Servant J-M
Centre Hospitalier de l'Université de Montréal, Université de Montréal, Service de Chirurgie Plastique, Hôpital Notre Dame, Montréal, Québec, Canada.
Ann Burns Fire Disasters. 2010 Jun 30;23(2):95-101.
Background. For the burn surgeon, the treatment of necrotizing soft tissue infections is one of the most demanding surgical emergencies, requiring "radical excisions" of the infected tissue and reconstruction. During the infection period, the excised sites are treated with application of gauzes soaked in saline solution. When the septic period is over, the excision sites are usually covered by sterile paraffin gauze dressing. Our aim was to evaluate a new calcium polyuronate dressing enriched with zinc and manganese ions (test group) versus the reference therapeutic combination (control group) from the septic period to the grafting of skin. Materials and methods. A multicentre, prospective, controlled, randomized clinical trial was conducted from November 2003 to July 2005. The primary endpoint was the waiting period for carrying out the skin graft and the percentage of grafted patients at 28 days after the last excision. The secondary endpoints were blood loss, exudates amounts, and pain during dressing changes. Results. Twenty-five patients were included, 14 with the new dressing and 11 with the reference therapeutic combination. The average waiting period for skin graft was 18 days in the test group versus 27.1 days in the control group (p = 0.128). All the patients in the test group received their grafts within 28 days after the last excision, compared with 60% (p = 0.043) in the control group. Bleeding during dressing change was statistically lower in the test group: 45.5% of the patients did not bleed compared with 0% in the control group (p = 0.045). Treatments were well tolerated. Conclusion. The properties of this new calcium polyuronate enriched with zinc and manganese ions seem to accelerate granulation tissue development, allowing skin grafting earlier in favourable conditions with less bleeding and less pain during dressing renewal.
背景。对于烧伤外科医生而言，坏死性软组织感染的治疗是最具挑战性的外科急症之一，需要对感染组织进行“根治性切除”并进行重建。在感染期，切除部位用浸有盐溶液的纱布处理。当感染期结束时，切除部位通常用无菌石蜡纱布敷料覆盖。我们的目的是评估一种富含锌和锰离子的新型聚uronate钙敷料（试验组）与从感染期到皮肤移植的参考治疗组合（对照组）的效果。材料和方法。2003年11月至2005年7月进行了一项多中心、前瞻性、对照、随机临床试验。主要终点是进行皮肤移植的等待期以及最后一次切除后28天移植患者的百分比。次要终点是失血、渗出量和换药时的疼痛。结果。纳入25例患者，14例使用新型敷料，11例使用参考治疗组合。试验组皮肤移植的平均等待期为18天，而对照组为27.1天（p = 0.128）。试验组所有患者在最后一次切除后28天内接受了移植，而对照组为60%（p = 0.043）。试验组换药时的出血在统计学上较低：45.5%的患者不出血，而对照组为0%（p =
