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局部治疗烧伤创面:磺胺嘧啶银与纳米晶银的随机对照比较

Healing of burn wounds by topical treatment: A randomized controlled comparison between silver sulfadiazine and nano-crystalline silver.

作者信息

Adhya Abhishek, Bain Jayanta, Ray Oindri, Hazra Avijit, Adhikari Souvik, Dutta Gouranga, Ray Sudhin, Majumdar Bijay Kumar

机构信息

Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

Department of Pharmacology, Meghnad Saha Institute of Technology, Kolkata, West Bengal, India.

出版信息

J Basic Clin Pharm. 2014 Dec;6(1):29-34. doi: 10.4103/0976-0105.145776.

Abstract

BACKGROUND

Silver sulfadiazine (SSD) has been the standard topical antimicrobial for burn wounds for decades. Recently, nanometer-sized silver particles are available which have high surface to volume ratio and remain effective even at a very low concentration and minimizes the chance for tissue toxicity due to silver. Hence, we conducted a randomized controlled trial to compare the effectiveness of topical SSD and nano-crystalline silver (AgNP) hydrogel in burn wounds management.

MATERIALS AND METHODS

Study was conducted in the Burn Unit of IPGME&R & SSKM Hospital Calcutta, from January 2011 to August 2012. Patients with 2° burn injury were randomly allocated to SSD and AgNP treatment group. Clinical assessments of burn wound were done on every week till 4(th) week and on completion of treatment.

RESULTS

Data for evaluation were obtained for 54 patients on SSD (2° deep-dermal cases 27) and 52 (2° deep-dermal cases 31) on AgNP treatment. Healing status of 2° deep-dermal burns was more satisfactory for AgNP group than SSD treatment at 4 weeks. Among patients receiving AgNP, 80.6% showed at least 50% healing of 2° deep-dermal wounds compared to 48.1% on SSD at 4 weeks (P = 0.001). The figures for complete healing at 4 weeks were, respectively, 4% and 0% (P = 0.116).

CONCLUSIONS

AgNP can be an effective and superior alternative to SSD for burn wounds, particularly 2° deep-dermal burns. Healing can be expected, in general, in 6 to 8 weeks time, depending upon the extent of body surface involvement.

摘要

背景

数十年来,磺胺嘧啶银(SSD)一直是治疗烧伤创面的标准外用抗菌药物。近来,出现了纳米级银颗粒,其具有高的表面积与体积比,即使在极低浓度下也能保持有效,并将银导致组织毒性的几率降至最低。因此,我们进行了一项随机对照试验,以比较外用SSD和纳米晶银(AgNP)水凝胶在烧伤创面处理中的有效性。

材料与方法

研究于2011年1月至2012年8月在加尔各答IPGME&R&SSKM医院烧伤科进行。将二度烧伤患者随机分配至SSD治疗组和AgNP治疗组。每周直至第4周以及治疗结束时对烧伤创面进行临床评估。

结果

获得了54例接受SSD治疗患者(27例深二度烧伤)和52例接受AgNP治疗患者(31例深二度烧伤)的评估数据。4周时,AgNP组深二度烧伤的愈合状况比SSD治疗组更令人满意。在接受AgNP治疗的患者中,80.6%的深二度创面至少愈合50%,而SSD治疗组4周时为48.1%(P = 0.001)。4周时完全愈合的比例分别为4%和0%(P = 0.116)。

结论

对于烧伤创面,尤其是深二度烧伤,AgNP可以成为SSD的一种有效且更优的替代物。一般而言,根据体表受累范围,预计在6至8周时间内可以愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f25f/4268627/fb91957aac09/JBCP-6-29-g002.jpg

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