Gerding R L, Emerman C L, Effron D, Lukens T, Imbembo A L, Fratianne R B
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
Ann Emerg Med. 1990 Feb;19(2):121-4. doi: 10.1016/s0196-0644(05)81793-7.
A randomized, prospective study comparing the use of Biobrane (group 1) with the use of 1% silver sulfadiazine (group 2) in treating 56 partial-thickness burn wounds was carried out in 52 outpatients with burns that comprised less than 10% of their total body surface area. The two groups were similar in age, gender, race, and extent of burn. Wounds of patients in group 1 (30) were compared with those of group 2 (26) for healing time, pain, compliance with scheduled visits, and costs. Infected and skin-grafted wounds were excluded from healing time analysis. Infection rates of the two groups were similar (three of 30 vs two of 26). One patient in each group underwent skin grafting. Healing times of group 1 wounds were significantly less than those of group 2 (10.6 +/- 0.8 vs 15.0 +/- 1.2 days, P less than .01). Using a pain scale of 1 to 5, Biobrane-treated patients averaged lower pain scores at 24 hours after the burn (1.6 +/- 0.8 vs 3.6 +/- 1.3 P less than .001) and used less pain medication. Compliance with scheduled outpatient visits was also improved in the Biobrane-treated group (88.6% vs 63.2% attendance, P less than .001). Idealized total treatment costs averaged $434 for patients in group 1 compared with $504 for patients in group 2. We conclude that when used on properly selected wounds, Biobrane therapy can significantly decrease pain and total healing time without increasing the cost of outpatient burn care. Improved patient compliance may be an added benefit.
一项随机前瞻性研究对52例烧伤面积小于全身表面积10%的门诊患者进行，比较生物膜（第1组）与1%磺胺嘧啶银（第2组）用于治疗56处浅二度烧伤创面的效果。两组患者在年龄、性别、种族和烧伤程度方面相似。比较第1组（30例）和第2组（26例）患者创面的愈合时间、疼痛程度、门诊复诊依从性及费用。愈合时间分析排除感染创面和植皮创面。两组感染率相似（30例中有3例，26例中有2例）。每组各有1例患者接受了植皮手术。第1组创面的愈合时间显著短于第2组（10.6±0.8天对15.0±1.2天，P＜0.01）。采用1至5分的疼痛量表，生物膜治疗的患者在烧伤后24小时的平均疼痛评分较低（1.6±0.8对3.6±1.3，P＜0.001），且使用的止痛药物较少。生物膜治疗组门诊复诊的依从性也有所提高（就诊率88.6%对63.2%，P＜0.001）。第1组患者理想化的总治疗费用平均为434美元，而第2组患者为504美元。我们得出结论，在正确选择的创面上使用生物膜治疗，可显著减轻疼痛、缩短总愈合时间，且不增加门诊烧伤护理费用。患者依从性的提高可能是额外的益处。
