Hassanpour Seyed Esmail, Moosavizadeh Seyed Mehdi, Yavari Masoud, Hallaj Mofrad Hamid Reza, Fadaei Alireza
Department of Plastic and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2013 Jan;2(1):26-32.
Split- thickness skin graft is one of the most common operations in plastic surgery. It is always painful and patient discomfort from donor site often is more significant than recipient site. There is not still a standard method for treatment of the donor site. The purpose of this study was to determine the best method of dressing the donor site among three different methods with respect to the rate of healing, pain, secretion, infection and cost.
The study includes 60 patients that were randomly divided into three groups. Donor site and thickness of the graft was the same and were dressed with one of the methods including Method A: Paraffin fine mesh gauze, Method B: Nitrofurazone soaked fine mesh gauze and Method C: Dry fine mesh gauze. Each method included an intermediate layer of sterile plastic sheet witch was covered with 10 layers of dry gauze. Comparison with respect to the rate of healing, pain, secretion, infection and cost was done.
Thirty seven patients were men and 23 were women. The mean age of the patients was 27.2 years. There was a significant difference between three methods in average time of repair and superiority of dressing with Method B was noted. Pain severity was the least in Method B and difference between the methods was significant. Dressing with Method B had the least secretion and there was a statistically significant difference between three methods. There was no statistically significant difference in cost of the management.
This study showed that dressing the donor site with nitrofurazone ointment soaked gauze used as the first layer of dressing and intermediate layer of sterile plastic sheet which was covered with 10 layers of dry gauze was the best method of dressing and had the least complications.
断层皮片移植是整形外科最常见的手术之一。该手术总是伴有疼痛,供皮区患者的不适通常比受皮区更明显。目前仍没有治疗供皮区的标准方法。本研究的目的是在三种不同方法中,根据愈合速度、疼痛程度、分泌物、感染情况和成本,确定最佳的供皮区包扎方法。
本研究纳入60例患者,随机分为三组。供皮区和移植皮片厚度相同,分别采用以下方法之一进行包扎:方法A:石蜡细网纱布;方法B:呋喃西林浸泡细网纱布;方法C:干细网纱布。每种方法均包括一层中间无菌塑料片,其上覆盖10层干纱布。对愈合速度、疼痛程度、分泌物、感染情况和成本进行比较。
37例患者为男性,23例为女性。患者平均年龄为27.2岁。三种方法在平均修复时间上存在显著差异,方法B的包扎效果最佳。方法B的疼痛程度最轻,各方法之间差异显著。方法B的分泌物最少,三种方法之间存在统计学显著差异。处理成本无统计学显著差异。
本研究表明,用呋喃西林软膏浸泡的纱布作为第一层敷料,中间层为无菌塑料片,其上覆盖10层干纱布,是包扎供皮区的最佳方法,并发症最少。