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负压敷料辅助小儿烧伤患者愈合。

Negative pressure dressing assisted healing in pediatric burn patients.

作者信息

Koehler Shannon, Jinbo Anne, Johnson Sidney, Puapong Devin, de Los Reyes Carl, Woo Russell

机构信息

University of Hawaii - Hawaii Residency Programs, General Surgery, 1356 Lusitana Street Suite 510, Honolulu, HI 96813.

Kapi'olani Medical Center for Women and Children, Department of Pediatric Surgery, 1319 Punahou St, Honolulu, HI 96826.

出版信息

J Pediatr Surg. 2014 Jul;49(7):1142-5. doi: 10.1016/j.jpedsurg.2014.02.040. Epub 2014 Feb 17.

Abstract

BACKGROUND/PURPOSE: Pediatric burn patients traditionally require multiple dressing changes and significant amounts of narcotics. Negative pressure dressings (NPDs) have emerged as an effective wound therapy that may represent an alternative primary dressing for these patients.

METHODS

This is a single institution, retrospective study of pediatric burn patients treated with NPDs over a defined 2 year period. Twenty-two patients were identified and their charts reviewed for age, sex, mode of injury, location of injury, degree of burn, length of stay, length of dressing required, number of dressing changes, and narcotic use between dressing changes.

RESULTS

The average patient was 3.5 years old (range of 8 months to 10 years old) with partial thickness burns involving 8.5% (range 3-18%) body surface area. The average treatment regimen was 3.5 dressing changes more than 6.6 days, with a mean hospital stay of 9.6 days. The average child received 9.4 total doses of delivered narcotics during their inpatient care.

DISCUSSION

The use of NPD in pediatric burn patients does require sedation and narcotics which limits its usefulness in the general pediatric burn population. Yet, they adhere well and stay in place even on active children, they capture and quantify fluid losses, they only require changes every 2-4 days and promote the adherence of split thickness skin grafts making them useful in various clinical situations.

CONCLUSIONS

NPDs are a viable option for both partial and full thickness burns in pediatric patients that do not require transfer to a burn unit. NPDs may be advantageous in highly active children, those with extensive fluid losses, those that require sedation for dressing changes and those that will require grafting.

摘要

背景/目的:传统上,小儿烧伤患者需要多次换药并使用大量麻醉药。负压敷料(NPDs)已成为一种有效的伤口治疗方法,可能是这些患者的一种替代性主要敷料。

方法

这是一项单机构回顾性研究,研究对象为在特定的2年期间接受NPDs治疗的小儿烧伤患者。确定了22例患者,并查阅了他们的病历,以了解年龄、性别、受伤方式、受伤部位、烧伤程度、住院时间、所需敷料长度、换药次数以及换药期间的麻醉药使用情况。

结果

患者平均年龄为3.5岁(8个月至10岁),二度烧伤累及体表面积的8.5%(范围为3%-18%)。平均治疗方案为在6.6天内换药3.5次,平均住院时间为9.6天。平均每个儿童在住院治疗期间共接受9.4剂麻醉药。

讨论

在小儿烧伤患者中使用NPD确实需要镇静和麻醉药,这限制了其在一般小儿烧伤人群中的应用。然而,它们粘附性良好,即使在活跃的儿童身上也能固定在位,它们能收集和量化液体流失,每2-4天只需更换一次,并且能促进中厚皮片的粘附,使其在各种临床情况下都有用。

结论

对于不需要转至烧伤病房的小儿患者,NPDs是治疗浅度和深度烧伤的可行选择。NPDs在极度活跃的儿童、液体大量流失的儿童、换药需要镇静的儿童以及需要植皮的儿童中可能具有优势。

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