Agha Riaz A, Agha Maliha
Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
Department of Public Health, King's College London, London, UK.
Ann Med Surg (Lond). 2012 Aug 14;1:49-54. doi: 10.1016/S2049-0801(12)70014-6. eCollection 2012.
Adults with burn scars are a clinical challenge, and the long term sequelae of burns can have a significant impact on the patient. Scar excision is thought to be the best treatment at present, as it results in a smaller scar. Scar stretching has shown promise in a previous study, as it may allow the surgeon to excise more burn scar. The goal of this study was to determine if good evidence exists for the use of burn scar stretching, in routine clinical practice, through the format of a critically appraised topic. A question was formulated using the Patient Intervention Comparator Outcome (PICO) method:-Patient - Adult burn victims-Intervention - Scar excision + skin stretching-Comparator - Scar excision-Outcome - Total remaining scar The PICO question was used to develop a search query: "stretch* burn scar" (where '*' represents a wildcard function). A search was then conducted using PubMed, SCOPUS, the Cochrane Library, and Trip Database. One paper was selected for critical appraisal following identification, screening, and eligibility evaluation. The paper was critically appraised using accepted methodology outlined by Straus et al. and reporting quality was assessed using the CONSORT statement for non-pharmacological trials. Areas of methodological or reporting weakness were highlighted. Burn scar stretching, using the device or technique in question, requires much further research before widespread usage in burns patients.
成年烧伤疤痕患者是一个临床挑战，烧伤的长期后遗症会对患者产生重大影响。目前认为疤痕切除是最佳治疗方法，因为它能形成较小的疤痕。在先前的一项研究中，疤痕拉伸已显示出前景，因为它可能使外科医生能够切除更多的烧伤疤痕。本研究的目的是通过严格评价主题的形式，确定在常规临床实践中使用烧伤疤痕拉伸是否有充分的证据。使用患者干预对照结局（PICO）方法提出了一个问题：
患者——成年烧伤受害者
干预——疤痕切除 + 皮肤拉伸
对照——疤痕切除
结局——剩余疤痕总量
PICO问题用于制定搜索查询：“stretch* burn scar”（其中“*”代表通配符功能）。然后使用PubMed、SCOPUS、Cochrane图书馆和Trip数据库进行搜索。在进行识别、筛选和资格评估后，选择了一篇论文进行严格评价。使用Straus等人概述的公认方法对该论文进行严格评价，并使用非药物试验的CONSORT声明评估报告质量。突出了方法学或报告方面的薄弱环节。在烧伤患者中广泛使用之前，使用相关设备或技术进行烧伤疤痕拉伸还需要进一步的研究。
