Hospital Schaffhausen, Schaffhausen, Switzerland.
Adv Skin Wound Care. 2013 Feb;26(2):67-73. doi: 10.1097/01.ASW.0000426715.57540.8d.
To compare postoperative healing of split-thickness skin graft (STSG) donor sites using traditional dressings (paraffin gauze) or modern wound dressings (alginate dressing and polyurethane film) in a randomized controlled trial.
Thirty patients were randomly assigned to treatment of an STSG donor site with an alginate dressing and a polyurethane film or nonadherent paraffin gauze. Outcome variables were pain (measured with a visual analog scale), amount of dressing changes, healing time, cosmetic outcome, treatment costs, and overall satisfaction with the procedure.
There was no significant difference in pain (postoperative day 1: 2.1 vs 1.2, P = .26; postoperative days 5-7: 1.0 vs 0.9, P = .47; final removal: 1.9 vs 1.0, P = .19) and time to healing (18.1 vs 15.4 days, P = .29) between alginate/polyurethane film dressing and nonadherent paraffin gauze. The semiocclusive dressings with polyurethane film required multiple dressing changes, whereas the nonadherent paraffin gauze could be left in place until complete epithelialization. Treatment costs were substantially lower for paraffin gauze.
Semiocclusive dressings with alginate dressings and polyurethane film showed no advantages over treatment with paraffin gauze. With lower costs and better patient acceptance, paraffin gauze dressings were the preferred treatment for STSG donor sites.
在一项随机对照试验中,比较传统敷料(石蜡纱布)和现代伤口敷料(藻酸盐敷料和聚氨酯薄膜)对供区切取刃厚皮片(split-thickness skin graft,STSG)后的愈合效果。
30 例患者随机分为藻酸盐敷料和聚氨酯薄膜或非粘性石蜡纱布治疗 STSG 供区。观察指标包括疼痛(采用视觉模拟评分法)、换药次数、愈合时间、美容效果、治疗费用和对治疗过程的总体满意度。
藻酸盐/聚氨酯薄膜组与非粘性石蜡纱布组在疼痛(术后第 1 天:2.1 比 1.2,P =.26;术后第 5-7 天:1.0 比 0.9,P =.47;最终去除敷料时:1.9 比 1.0,P =.19)和愈合时间(18.1 天比 15.4 天,P =.29)方面无显著差异。而具有聚氨酯薄膜的半封闭敷料需要多次换药,而非粘性石蜡纱布可在完全上皮化前保留在原处。石蜡纱布的治疗费用明显更低。
藻酸盐敷料和聚氨酯薄膜的半封闭敷料在治疗 STSG 供区方面没有比石蜡纱布更有优势。由于成本更低且患者接受度更高,石蜡纱布敷料是 STSG 供区的首选治疗方法。