比较水凝胶银敷料与凡士林纱布及1%磺胺嘧啶银乳膏治疗中毒性表皮坏死松解症疗效的临床评估
Clinical evaluation comparing the efficacy of aquacel Ag with vaseline gauze versus 1% silver sulfadiazine cream in toxic epidermal necrolysis.
作者信息
Huang Shu-Hung, Lin Cen-Hung, Chang Kao-Ping, Wu Sheng-Hua, Lin Sin-Daw, Lai Chung-Sheng, Ou Su-Fei, Lee Su-Shin
机构信息
Shu-Hung Huang, MD, is a Plastic Surgeon at the Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; a Student at the Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; an Assistant Professor at the Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; and a Plastic Surgeon at the Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan. Cen-Hun Lin, MD, is a Surgical Resident at the Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Kao-Ping Chang, MD, PhD, is a Chief of the Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; and Associate Professor at the Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Sheng-Hua Wu, MD, is a Student at the Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; and an Anesthesiologist at the Department of Anesthesia, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Sin-Daw Lin, MD, is a Plastic Surgeon at the Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; and a Professor at the Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Chung-Sheng Lai, MD, PhD, is a Plastic Surgeon at the Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; and a Professor at the Department of Surgery, Faculty of Medicine, College of Medicine, Kaohs
出版信息
Adv Skin Wound Care. 2014 May;27(5):210-5. doi: 10.1097/01.ASW.0000445919.06416.32.
OBJECTIVE
The purpose of this study was to determine whether using Aquacel Ag (ConvaTec, Skillman, New Jersey) with Vaseline (Unilever, London, England) gauze instead of silver sulfadiazine cream (SSD) as the wound care protocol to treat toxic epidermal necrolysis (TEN) can improve wound healing, pain control, and reduction of labor costs.
DESIGN
A retrospective chart review.
SETTING
A burn center with 2 plastic surgeons and 11 nursing staff.
PATIENTS
A pathologist diagnosed TEN in 35 patients admitted to the burn center from 1995 to 2009.
MAIN OUTCOME MEASURES
Parameters included the patient's profile, dressing choice, severity-of-illness score for TEN, time to 95% re-epithelialization, visual analog scale pain scores before second dressing change, and labor cost. The exclusion criterion was wound care with neither Aquacel Ag with Vaseline nor SSD exclusively.
RESULTS
Twenty patients were enrolled in this study. In the group using Aquacel Ag with Vaseline gauze, the visual analog scale score was significantly less than that of the SSD group (P = .02). Labor costs were significantly lower in the Aquacel Ag with Vaseline gauze group (P < .01). Commencement of specific dressing to 95% re-epithelialization (P = .09) and time spent in the second dressing change (P = .05) had no statistical significance between the 2 groups.
CONCLUSIONS
This study showed that Aquacel Ag with Vaseline gauze decreased pain and labor costs but did not shorten wound healing time. Thus, Aquacel Ag with Vaseline gauze can be an efficient method for treating TEN wounds.
目的
本研究旨在确定使用爱康肤银敷料（康维德公司，新泽西州斯基尔曼）加凡士林纱布（联合利华公司，英国伦敦）代替磺胺嘧啶银乳膏（SSD）作为伤口护理方案来治疗中毒性表皮坏死松解症（TEN）是否能改善伤口愈合、控制疼痛并降低劳动力成本。
设计
一项回顾性病历审查。
地点
一家拥有两名整形外科医生和11名护理人员的烧伤中心。
患者
1995年至2009年期间，一名病理学家确诊35名入住该烧伤中心的患者患有TEN。
主要观察指标
参数包括患者资料、敷料选择、TEN疾病严重程度评分、95%再上皮化时间、第二次换药前视觉模拟评分疼痛分数以及劳动力成本。排除标准为既未单独使用爱康肤银敷料加凡士林也未单独使用SSD进行伤口护理。
结果
本研究纳入20名患者。在使用爱康肤银敷料加凡士林纱布的组中，视觉模拟评分显著低于SSD组（P = 0.02）。爱康肤银敷料加凡士林纱布组的劳动力成本显著更低（P < 0.01）。两组之间从开始使用特定敷料到95%再上皮化（P = 0.09）以及第二次换药所花费的时间（P = 0.05）无统计学意义。
结论
本研究表明，爱康肤银敷料加凡士林纱布可减轻疼痛和降低劳动力成本，但并未缩短伤口愈合时间。因此，爱康肤银敷料加凡士林纱布可作为治疗TEN伤口的一种有效方法。
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