Tanaka H, Arai K, Fujino A, Takeda N, Watanabe T, Fuchimoto Y, Kanamori Y
Division of Surgery, National Centre for Child Health and Development, Tokyo, Japan.
J Wound Care. 2013 Jan;22(1):17-8, 20. doi: 10.12968/jowc.2013.22.1.17.
To estimate the efficacy of sprinkling salt treatment (SS) of hypergranulation at gastrostomy sites in paediatric patients.
A prospective case-series study of paediatric patients with hypergranulation at gastrostomy sites. About one-third of a 5ml-teaspoon of table salt was sprinkled over the tissue once a day, either by the doctors/nurses in the wards or doctors in the outpatient setting. Treatment was continued by the patients or carers in the home, until the hypergranulation was seen to flatten. The patients were followed up by health professionals once a month.
Eight paediatric patients (seven females and one male) were included in the study. The hypergranulation decreased in size and became almost flat in all patients within 3 days to 2 months (median 7 days). Five patients had a recurrence of hypergranulation, but were treated successfully by repeated SS. Skin erosion was observed in one patient when SS was continued too long; therefore, the treatment protocol was altered so that the salt was irrigated 10 minutes after SS. A biopsy of the hypergranulation tissue was taken from a patient and salt was sprinkled on the tissue in a dish to simulate SS for histopathological examination. Histopathologically, hypergranulation treated by SS exhibited reduced interstitial oedema.
The results of this study suggest that hypertonic environment induced by SS effectively reduced the oedematous hypergranulation tissue. SS is advantageous over traditional treatment such as silver nitrate in that SS is inexpensive and can be continued by the parents and repeated if necessary at home.
评估小儿患者胃造口部位肉芽组织增生的撒盐疗法（SS）的疗效。
对胃造口部位出现肉芽组织增生的小儿患者进行前瞻性病例系列研究。每天由病房的医生/护士或门诊医生在组织上撒约5毫升茶匙量三分之一的食盐。患者或护理人员在家中持续进行治疗，直至肉芽组织增生变平。卫生专业人员每月对患者进行一次随访。
8例小儿患者（7例女性，1例男性）纳入研究。所有患者的肉芽组织增生在3天至2个月内（中位数7天）尺寸减小并几乎变平。5例患者出现肉芽组织增生复发，但通过重复撒盐疗法成功治愈。1例患者在撒盐疗法持续时间过长时出现皮肤糜烂；因此，改变治疗方案，在撒盐后10分钟进行盐水冲洗。从1例患者身上取肉芽组织增生组织进行活检，并在培养皿中在组织上撒盐以模拟撒盐疗法进行组织病理学检查。组织病理学上，撒盐疗法治疗的肉芽组织增生表现为间质水肿减轻。
本研究结果表明，撒盐疗法诱导的高渗环境有效减轻了水肿性肉芽组织增生。与硝酸银等传统治疗方法相比，撒盐疗法具有优势，因为它价格低廉，家长可在家中持续进行，必要时可重复使用。
