Tang Hongtai, Lv Guozhong, Fu Jinfeng, Niu Xihua, Li Yeyang, Zhang Mei, Zhang Guoʼan, Hu Dahai, Chen Xiaodong, Lei Jin, Qi Hongyan, Xia Zhaofan
From the Department of Burn Surgery (H.T., Z.X., M.Z.), Changhai Hospital, Second Military Medical University, Shanghai; Department of Burn Surgery (G.L.), the 3rd People's Hospital of Wuxi, Jiangsu; Department of Burn Surgery (J.F.), the 2nd Affiliated Hospital of Kunming Medical University, Yunnan; Department of Burn Surgery (X.N.), the 1st People's Hospital of ZhengZhou, Henan; Department of Burn Surgery (Y.L.), Guangzhou Red Cross Hospital, Guangdong; Department of Burn Surgery (G.Z.), Beijing Jishuitan Hospital, Beijing; Department of Burn Surgery (D.H.), Xijing Hospital, Shaanxi; Department of Burn Surgery (X.C.), the First People's Hospital of Fushan, Guangdong; Shanxi Province Burn Care Center (J.L.), Shanxi; and Department of Burn Surgery (H.Q.), Beijing Children's Hospital, Beijing, China.
J Trauma Acute Care Surg. 2015 May;78(5):1000-7. doi: 10.1097/TA.0000000000000620.
Partial-thickness burns are among the most frequently encountered types of burns, and numerous dressing materials are available for their treatment. A multicenter, open, randomized, and parallel study was undertaken to determine the efficacy and tolerability of silver sulfadiazine (SSD) compared with an absorbent foam silver dressing, Mepilex Ag, on patients aged between 5 years and 65 years with deep partial-thickness thermal burn injuries (2.5-25% total body surface area).
Patients were randomly assigned to either SSD (n = 82) applied daily or a Mepilex Ag dressing (n = 71) applied every 5 days to 7 days. The treatment period was up to 4 weeks.
There was no significant difference between the two treatment groups with respect to the primary end point of time to healing, which occurred in 56 (79%) of 71 patients after a median follow-up time of 15 days in the Mepilex Ag group compared with 65 (79%) of 82 patients after a median follow-up time of 16 days in the SSD group (p = 0.74). There was also no significant difference in the percentage of study burn healed. Patients in the Mepilex Ag group had 87.1% of their study burn healed (out of the total burn area) compared with 85.2% of patients in the SSD group. However, the mean total number of dressings used was significantly more in the SSD group (14.0) compared with the Mepilex Ag group (3.06, p < 0.0001). There was no significant difference in the time until skin graft was performed between the two study groups.
There was no difference in healing rates between Mepilex Ag and SSD, with both products well tolerated. The longer wear time of Mepilex Ag promotes undisturbed healing and makes it easier for patients to continue with their normal lives sooner.
Therapeutic study, level III.
浅度烧伤是最常见的烧伤类型之一,有多种敷料可用于治疗。开展了一项多中心、开放、随机平行研究,以确定磺胺嘧啶银(SSD)与吸收性泡沫银敷料美皮康银(Mepilex Ag)相比,对年龄在5岁至65岁之间、深Ⅱ度热烧伤(占体表面积2.5%-25%)患者的疗效和耐受性。
患者被随机分为两组,一组每天使用SSD(n = 82),另一组每5天至7天使用一次Mepilex Ag敷料(n = 71)。治疗期最长为4周。
在愈合时间这一主要终点方面,两组之间无显著差异。美皮康银组71例患者中有56例(79%)在中位随访时间15天后愈合,而磺胺嘧啶银组82例患者中有65例(79%)在中位随访时间16天后愈合(p = 0.74)。研究烧伤愈合的百分比也无显著差异。美皮康银组患者的研究烧伤愈合率为87.1%(占总烧伤面积),而磺胺嘧啶银组为85.2%。然而,磺胺嘧啶银组使用的敷料平均总数(14.0)显著多于美皮康银组(3.06,p < 0.0001)。两组之间进行皮肤移植的时间无显著差异。
美皮康银和磺胺嘧啶银的愈合率无差异,两种产品耐受性均良好。美皮康银的较长使用时间促进了不受干扰的愈合,使患者更容易更快地继续正常生活。
治疗性研究,Ⅲ级。