Gopalakrishnan P N, Goel N, Banerjee Sujoy
Department of Neonatology, Singleton Hospital, ABM University NHS Trust, Sketty Lane,Swansea, Wales, SA2 8QA, UK.
Cochrane Database Syst Rev. 2012 Feb 15(2):CD008404. doi: 10.1002/14651858.CD008404.pub2.
Extravasation injury is a common complication of neonatal intensive care and can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are used in practice including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, different topical applications and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications.
To determine the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration on tissue healing in neonates with extravasation injury when compared to no intervention or normal wound care.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1950 to June 2011), EMBASE (Jan 1980 to June 2011), CINAHL (Jan 1988 to June 2011) and the Web of Science (up to July 2011).
Randomised controlled trials (RCT) and quasi-randomised controlled trials comparing saline irrigation with or without hyaluronidase infiltration with no intervention or normal wound care in the management of extravasation injury in neonates.
Three review authors independently reviewed and identified articles for possible inclusion in this review.
No eligible studies were found. There were a few case reports and case series describing successful outcomes with different interventions in this condition.
AUTHORS' CONCLUSIONS: To date, no randomised controlled trial is available that examines the effects of saline irrigation with or without prior hyaluronidase infiltration in the management of extravasation injury in neonates. Saline irrigation is a frequently reported intervention in the literature that is used in the management of extravasation injury in neonates. Research should be initially directed at evaluating the efficacy and safety of this intervention through randomised controlled trials. It will also be important to determine the size of the effect according to timing of intervention, nature of the infusate and the severity of injury at the time of intervention.
外渗性损伤是新生儿重症监护中的常见并发症，可导致瘢痕形成并伴有美容和功能后遗症。实际应用中使用了多种治疗方法，包括用盐水皮下冲洗（加或不加透明质酸酶）、抽脂、使用特定解毒剂、不同的局部应用以及使用干敷料或湿敷料的常规伤口护理。所有这些治疗旨在预防或减轻并发症的严重程度。
与不干预或常规伤口护理相比，确定盐水冲洗或预先用透明质酸酶浸润后进行盐水冲洗对新生儿外渗性损伤组织愈合的有效性和安全性。
我们检索了Cochrane对照试验中心注册库（CENTRAL）（《Cochrane图书馆》2011年第2期）、MEDLINE（1950年至2011年6月）、EMBASE（1980年1月至2011年6月）、CINAHL（1988年1月至2011年6月）以及科学引文索引（截至2011年7月）。
比较在新生儿外渗性损伤处理中，使用或不使用透明质酸酶浸润的盐水冲洗与不干预或常规伤口护理的随机对照试验（RCT）和半随机对照试验。
三位综述作者独立查阅并确定可能纳入本综述的文章。
未找到符合条件的研究。有一些病例报告和病例系列描述了在此情况下不同干预措施的成功结果。
迄今为止，尚无随机对照试验研究在新生儿外渗性损伤处理中，使用或不使用预先透明质酸酶浸润的盐水冲洗的效果。盐水冲洗是文献中经常报道的用于新生儿外渗性损伤处理的干预措施。研究应首先通过随机对照试验评估该干预措施的有效性和安全性。根据干预时机、输注液性质以及干预时损伤的严重程度确定效应大小也很重要。
