Assadian Ojan, Arnoldo Brett, Purdue Gary, Burris Agnes, Skrinjar Edda, Duschek Nikolaus, Leaper David J
Department for Hospital Hygiene, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Int Wound J. 2015 Jun;12(3):351-6. doi: 10.1111/iwj.12136. Epub 2013 Aug 6.
This prospective, randomised study compares a new transforming methacrylate dressing (TMD) with a silver-containing carboxymethylcellulose dressing (CMC-Ag) after application to split-thickness skin graft (STSG) donor sites. This was an unblinded, non-inferiority, between-patient, comparison study that involved patients admitted to a single-centre burn unit who required two skin graft donor sites. Each patient's donor sites were covered immediately after surgery: one donor site with TMD and the other with CMC-Ag. The donor sites were evaluated until healing or until 24 days post-application, whichever came first. Study endpoints were time to healing, daily pain scores, number of dressing changes, patient comfort and physicians' and patients' willingness to use the dressings in the future. Nineteen patients had both the dressings applied. No statistically significant difference was noted in time to healing between the two dressings (14·2 days using TMD compared with 13·2 days using CMC-Ag). When pain scores were compared, TMD resulted in statistically significantly less pain at three different time periods (2-5 days, 6-10 days and 11-15 days; P < 0·001 at all time periods). Patients also reported greater comfort with TMD (P < 0·001). Users rated TMD as being less easy to use because of the time and technique required for application. Reductions in pain and increased patient comfort with the use of the TMD dressing, compared with CMC-Ag, were seen as clinical benefits as these are the major issues in donor site management.
这项前瞻性随机研究比较了一种新型的甲基丙烯酸酯转化敷料(TMD)与含银羧甲基纤维素敷料(CMC-Ag)应用于中厚皮片(STSG)供皮区后的效果。这是一项非盲法、非劣效性、患者间比较研究,涉及入住单中心烧伤病房且需要两个皮肤移植供皮区的患者。每位患者的供皮区在手术后立即进行覆盖:一个供皮区使用TMD,另一个使用CMC-Ag。对供皮区进行评估,直至愈合或直至应用后24天,以先到者为准。研究终点包括愈合时间、每日疼痛评分、换药次数、患者舒适度以及医生和患者未来使用敷料的意愿。19名患者的两个供皮区都应用了这两种敷料。两种敷料在愈合时间上没有统计学显著差异(使用TMD为14.2天,使用CMC-Ag为13.2天)。比较疼痛评分时,TMD在三个不同时间段(2 - 5天、6 - 10天和11 - 15天)导致的疼痛在统计学上显著减轻(所有时间段P < 0.001)。患者也报告使用TMD时舒适度更高(P < 0.001)。使用者认为由于应用所需的时间和技术,TMD不太容易使用。与CMC-Ag相比,使用TMD敷料可减轻疼痛并提高患者舒适度,这些被视为临床益处,因为它们是供皮区管理中的主要问题。