Malin Edward W, Galin Chaya M, Lairet Kimberley F, Huzar Todd F, Williams James F, Renz Evan M, Wolf Steven E, Cancio Leopoldo C
From the US Army Institute of Surgical Research, Fort Sam Houston, TX.
Ann Plast Surg. 2013 Nov;71(5):481-4. doi: 10.1097/SAP.0b013e31829d2311.
Burn wounds are a significant cause of morbidity and mortality, and improved outcomes are demonstrated with early closure of both primary burn wounds and skin donor sites. Thus, technology that decreases the healing time of burns and donor sites would be potentially lifesaving. We present the results of a single-center, prospective, double-blinded, randomized controlled trial to evaluate the efficacy of silver-coated dressing with active microcurrent in comparison to silver-coated dressing with sham microcurrent on wound-closure time for autogenous skin donor sites.
Four hundred five patients were screened for treatment of their donor sites using a silver-coated nylon dressing with either sham or active microcurrent stimulation. Thirty patients were enrolled in the study and then randomized. Of these, 5 patients were removed from analysis due to protocol deviations. Differences in time-to-closure were analyzed using Kaplan-Meier analysis and the proportional hazard regression model. Subjective verbal pain rating scores (0-10; 0, no pain; 10, worst pain) were also recorded. All devices were blinded and programmed at an outside facility, so that every patient had either an active or sham device. The study was unblinded only after the final patient's donor site had healed. All patients achieved donor-site healing before postoperative day 20. The 14 patients in the active microcurrent group [mean, 10.8 (2.9) days; range, 7-15 days] experienced no difference in time to wound healing as compared to the remaining patients in the sham microcurrent group [mean, 11.1 (2.0) days; range, 8-14 days; P = 0.75]. There were no differences in pain from one group compared to the other. None of the donor sites exhibited clinical signs of infection.
In a sample size of 25 burn patients, the addition of direct microcurrent to silver-nylon dressings did not decrease time to wound closure of skin donor sites, and it did not show a difference in reported pain levels.
烧伤创面是发病和死亡的重要原因,早期封闭原发性烧伤创面和皮肤供区可改善预后。因此,缩短烧伤创面和供区愈合时间的技术可能会挽救生命。我们进行了一项单中心、前瞻性、双盲、随机对照试验,以评估具有活性微电流的镀银敷料与具有假微电流的镀银敷料相比,对自体皮肤供区创面闭合时间的疗效。
使用具有假微电流或活性微电流刺激的镀银尼龙敷料对405例患者的供区进行治疗筛选。30例患者被纳入研究并随即分组。其中,5例患者因违反方案被排除在分析之外。使用Kaplan-Meier分析和比例风险回归模型分析愈合时间的差异。还记录了主观言语疼痛评分(0-10分;0分表示无疼痛;10分表示最剧烈疼痛)。所有设备均在外部机构进行盲法设置和编程,以便每位患者使用活性或假设备。仅在最后一名患者的供区愈合后才解除盲法。所有患者均在术后第20天前实现供区愈合。活性微电流组的14例患者[平均,10.8(2.9)天;范围,7-15天]与假微电流组的其余患者相比,创面愈合时间无差异[平均,11.1(2.0)天;范围,8-14天;P = 0.75]。两组之间的疼痛无差异。所有供区均未出现感染的临床迹象。
在25例烧伤患者的样本中,在镀银尼龙敷料上添加直接微电流并未缩短皮肤供区创面的闭合时间,且在报告的疼痛水平上也未显示出差异。