Strong Amy L, Nauta Allison C, Kuang Anna A
Tulane University School of Medicine, New Orleans, LA.
Oregon Health & Science University, Portland, OR.
Wounds. 2015 Dec;27(12):319-26.
This study highlights and validates a peroxide-based wound healing strategy for treatment of surgically closed facial wounds in a pediatric population. The authors identified pediatric patients undergoing primary cleft lip repair as a specific population to evaluate the outcomes of such a protocol. Through analysis of defined outcome measures, a reliable and reproducible protocol for postoperative wound care following primary cleft lip repair with favorable results is described.
This retrospective study analyzes wound healing outcomes in pediatric patients undergoing primary cleft lip repair from 2006 to 2011 at a tertiary academic center. The wound healing protocol was used in both primary unilateral and bilateral repairs. One hundred fortysix patients between the ages of 0 and 4 years underwent primary cleft lip repair and cleft rhinoplasty by a single, fellowship-trained craniofacial surgeon. Postoperatively, wounds were treated with half-strength hydrogen peroxide and bacitracin, as well as scar massage. Incisional dehiscence, hypertrophic scar formation, discoloration, infection, and reoperation were studied. Outcomes were evaluated in light of parent compliance, demographics, preoperative nasoalveolar molding (PNAM), and diagnosis.
The authors identified 146 patients for inclusion in this study. There was no wound or incisional dehiscence. One hundred twenty-four patients demonstrated favorable cosmetic outcome. Only 3 (2%) of patients who developed suboptimal outcomes underwent secondary surgical revision (> 1 year after surgery). Demographic differences were not statistically significant, and PNAM treatment did not influence outcomes.
These data validate the use of halfstrength hydrogen peroxide and bacitracin as part of a wound healing strategy in pediatric incisional wounds. The use of hydrogen peroxide produced comparable outcomes to previously published studies utilizing other wound healing strategies and, therefore, these study findings support the further use of this regimen for this particular population.
本研究着重介绍并验证一种基于过氧化物的伤口愈合策略，用于治疗儿科患者外科闭合的面部伤口。作者将接受一期唇裂修复术的儿科患者确定为评估该方案效果的特定人群。通过对明确的结局指标进行分析，描述了一种可靠且可重复的一期唇裂修复术后伤口护理方案，其效果良好。
这项回顾性研究分析了2006年至2011年在一家三级学术中心接受一期唇裂修复术的儿科患者的伤口愈合结果。该伤口愈合方案用于一期单侧和双侧修复。146名年龄在0至4岁之间的患者由一名接受过专科培训的颅面外科医生进行了一期唇裂修复和鼻成形术。术后，伤口用半强度过氧化氢和杆菌肽治疗，以及进行瘢痕按摩。研究了切口裂开、肥厚性瘢痕形成、色素沉着、感染和再次手术情况。根据家长的依从性、人口统计学、术前鼻牙槽塑形（PNAM）和诊断对结果进行了评估。
作者确定了146名患者纳入本研究。没有伤口或切口裂开情况。124名患者显示出良好的美容效果。只有3名（2%）效果欠佳的患者接受了二次手术修复（术后>1年）。人口统计学差异无统计学意义，PNAM治疗也不影响结果。
这些数据验证了半强度过氧化氢和杆菌肽作为儿科切口伤口愈合策略一部分的应用。过氧化氢的使用产生了与先前发表的使用其他伤口愈合策略的研究相当的结果，因此，这些研究结果支持在这一特定人群中进一步使用该方案。
