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评估羊膜在烧伤患者皮肤移植供区敷料中的有效性。

Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients.

作者信息

Salehi Seyed Hamid, As'adi Kamran, Mousavi Seyed Jaber, Shoar Saeed

机构信息

Department of General Surgery, Burn Research Center, Motahari Burn Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Plastic and Reconstructive Surgery, Burn Research Center, Motahari Burn Hospital, Tehran University of Medical Sciences, Rashid Yasami St., Vali-e- Asr Ave., Tehran, Iran.

出版信息

Indian J Surg. 2015 Dec;77(Suppl 2):427-31. doi: 10.1007/s12262-013-0864-x. Epub 2013 Jan 31.

Abstract

Although the recipient site in burn wounds is dressed with universally accepted materials, the ideal management of split-thickness skin donor sites remains controversial. The aim of our study is to compare two methods of wound dressing in donor sites of split-thickness skin graft in patients undergoing burn wound reconstructive surgery. Forty-two consecutive patients with second- and third-degree burns with a total body surface area between 20 and 40 % were enrolled in this randomized clinical trial conducted in Motahari Burn Hospital in Tehran, Iran. In each patient, two anatomic areas with similar features were randomly selected as intervention and control donor sites. The intervention site was dressed with amniotic membrane, whereas the control site was treated with Vaseline-impregnated gauze. Wounds were examined daily by expert surgeons to measure the clinical outcomes including duration of healing, severity of pain, and infection rate. The mean ± SD age of patients was 31.17 ± 13.72 years; furthermore, burn percentage had a mean ± SD of 31.19 ± 10.56. The mean ± SD of patients' cooperation score was 1.6 ± 0.79 in the intervention group compared with 2.93 ± 0.71 in the control group, revealing a statistically significant difference (P < 0.05). Duration of wound healing was significantly shorter (P < 0.05) in the intervention group (17.61 ± 2.56 days) compared with the control group (21.16 ± 3.45 days). However, there was no significant difference in terms of wound infection rate between donor sites in the control and intervention groups (P > 0.05). Amniotic membrane as an alternative for dressing of skin graft donor sites provides significant benefits by increasing patients' comfort via diminishing the number of dressing changes and facilitating the process of wound healing.

摘要

尽管烧伤创面的受皮区采用了普遍认可的材料进行包扎,但对于中厚皮片供皮区的理想处理方法仍存在争议。我们研究的目的是比较烧伤创面重建手术患者中厚皮片供皮区的两种伤口包扎方法。在伊朗德黑兰的莫塔哈里烧伤医院进行的这项随机临床试验中,连续纳入了42例二度和三度烧伤且总体表面积在20%至40%之间的患者。在每位患者身上,随机选择两个特征相似的解剖区域作为干预和对照供皮区。干预部位用羊膜包扎,而对照部位用凡士林纱布处理。由专业外科医生每天检查伤口,以测量临床结果,包括愈合时间、疼痛程度和感染率。患者的平均年龄±标准差为31.17±13.72岁;此外,烧伤面积的平均±标准差为31.19±10.56。干预组患者的合作评分平均±标准差为1.6±0.79,而对照组为2.93±0.71,差异有统计学意义(P<0.05)。干预组伤口愈合时间(17.61±2.56天)明显短于对照组(21.16±3.45天)(P<0.05)。然而,对照组和干预组供皮区的伤口感染率无显著差异(P>0.05)。羊膜作为皮肤移植供皮区的包扎替代品,通过减少换药次数和促进伤口愈合过程来提高患者舒适度,从而带来显著益处。

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