羊膜对烧伤患者的治疗作用
The Healing Effect of Amniotic Membrane in Burn Patients.
作者信息
Eskandarlou Mahdi, Azimi Mina, Rabiee Soghra, Seif Rabiee Mohammad Ali
机构信息
Department of General Surgery, Hamadan University of Medical Sciences, Besat Hospital, Hamadan, Iran;
Department of Obstetrics and Genecology, Hamadan University of Medical Sciences, Fatemieh Hospital, Hamadan, Iran;
出版信息
World J Plast Surg. 2016 Jan;5(1):39-44.
BACKGROUND
Different methods for dressing of donor site of skin graft in burn patients have similarly pain, limitation of mobility of donor site and local complications such as infection and scar. Amniotic membrane has used for improvement of healing in some wounds. Accordingly in this study amnion was used as biologic dressing for donor site of skin graft to evaluate it's efficacy in improvement of pain, move score and the risk of local infection.
METHODS
Study was done as clinical trial over 32 admitted patients in burn department of Beasat hospital. Amnion was prepared in elective caesarean section after rule out any placental site for risk of torch and viral infection. Skin graft was taken from two sites in every patient. One site dressed with amnion and another with routine dressing. Then two sites were compared about severity of pain, move score, infection and time of dressing sloughing.
RESULTS
Fourteen patients were women and 18 men. Mean score of pain and movement up to fourth and fifth post operative day respectively was less than control site. No difference is seen about infection and dressing slough in two sites.
CONCLUSION
It seems use of amnion for dressing of donor site probably cause rapid epithelialisation and wound healing and can improve pain and move score in early post operative days. Accordingly it is expected to need less analgesia and low rate of immobilization and following complications and earlier discharge of patients.
背景
烧伤患者皮肤移植供区的不同敷料包扎方法在疼痛、供区活动受限以及局部并发症（如感染和瘢痕）方面表现相似。羊膜已被用于促进某些伤口的愈合。因此，在本研究中，羊膜被用作皮肤移植供区的生物敷料，以评估其在减轻疼痛、提高活动评分和降低局部感染风险方面的效果。
方法
本研究作为一项临床试验，对Beasat医院烧伤科收治的32例患者进行。在择期剖宫产时制备羊膜，排除任何有感染风险的胎盘部位。每位患者从两个部位取皮。一个部位用羊膜包扎，另一个部位用常规敷料包扎。然后比较两个部位在疼痛程度、活动评分、感染情况和敷料脱落时间方面的差异。
结果
14例为女性，18例为男性。术后第4天和第5天，使用羊膜包扎部位的疼痛和活动平均评分分别低于对照部位。两个部位在感染和敷料脱落方面未见差异。
结论
使用羊膜包扎皮肤移植供区可能会促进上皮化和伤口愈合，并在术后早期改善疼痛和活动评分。因此，预计需要更少的镇痛药物，固定率降低，并发症减少，患者可更早出院。
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