Liuzzi Francesca, Chadwick Sarah, Shah Mamta
University of Manchester School of Medicine, Stopford 3.614, Oxford Road, Manchester M13 9PT, United Kingdom.
University of Manchester School of Medicine, Stopford 3.614, Oxford Road, Manchester M13 9PT, United Kingdom; Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, United Kingdom.
Burns. 2015 Mar;41(2):252-6. doi: 10.1016/j.burns.2014.10.017. Epub 2014 Nov 17.
Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems. In the current literature there is great variation in post-burn scar management across the world and in the evidence available for the efficacy of these management modalities. The aim of this study was to investigate the variances if any, in the management of post-burn scarring in children across the UK. A telephone survey of UK paediatric burn services was conducted to obtain information on post-burn scar management and advice given to patients/carers. Of the 19 burn services that participated, all advised moisturising of scars but with variable emphasis on massaging. Silicones and pressure therapy were used by 18 services but commencement of use varied from soon after healing to onset of hypertrophic scarring. Laser therapy, ultrasound therapy and steroid therapy were used sporadically. This study highlights the common modalities of post-burn scar management in children across the UK. However, there is marked variation in timing and selection of the commonly used modalities. Although this study did not investigate the outcomes of scar management, it clearly identifies the need for a well-designed multi-centred study to establish evidence-based best practice in the management of post-burn scarring in children as these modalities are time consuming and not without potential complications. Evidence based practice could potentially lead to significant financial savings to the health service.
在英国,每年有25万人受到热损伤。随着烧伤存活率的提高,良好的瘢痕管理对于帮助有瘢痕的患者过上不受限制的生活至关重要。烧伤后增生性瘢痕会限制儿童生长,影响功能并引发心理问题。在当前文献中,世界各地烧伤后瘢痕管理方法以及这些管理方式疗效的现有证据差异很大。本研究的目的是调查英国各地儿童烧伤后瘢痕管理方面是否存在差异。对英国儿科烧伤服务机构进行了电话调查,以获取烧伤后瘢痕管理信息以及给予患者/护理人员的建议。在参与调查的19家烧伤服务机构中,所有机构都建议对瘢痕进行保湿,但对按摩的重视程度各不相同。18家机构使用了硅胶和压力疗法,但开始使用的时间从愈合后不久到增生性瘢痕出现不等。激光疗法、超声疗法和类固醇疗法使用较少。本研究突出了英国各地儿童烧伤后瘢痕管理的常见方式。然而,常用方式的时机选择和使用存在显著差异。尽管本研究未调查瘢痕管理的结果,但明确指出需要开展一项精心设计的多中心研究,以确立儿童烧伤后瘢痕管理的循证最佳实践,因为这些方式耗时且并非没有潜在并发症。循证实践可能会为医疗服务节省大量资金。
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