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外用硅胶凝胶和压力衣疗法对儿童烧伤疤痕预防和治疗的有效性:一项随机对照试验的研究方案

Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: study protocol for a randomised controlled trial.

作者信息

Wiseman Jodie, Simons Megan, Kimble Roy, Ware Robert, McPhail Steven, Tyack Zephanie

机构信息

Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, The University of Queensland, Brisbane, QLD, Australia.

Pegg Leditschke Children's Burns Centre, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.

出版信息

Trials. 2017 Feb 16;18(1):72. doi: 10.1186/s13063-017-1820-z.

Abstract

BACKGROUND

Abnormal scar development following burn injury can cause substantial physical and psychological distress to children and their families. Common burn scar prevention and management techniques include silicone therapy, pressure garment therapy, or a combination of both. Currently, no definitive, high-quality evidence is available for the effectiveness of topical silicone gel or pressure garment therapy for the prevention and management of burn scars in the paediatric population. Thus, this study aims to determine the effectiveness of these treatments in children.

METHODS

A randomised controlled trial will be conducted at a large tertiary metropolitan children's hospital in Australia. Participants will be randomised to one of three groups: Strataderm® topical silicone gel only, pressure garment therapy only, or combined Strataderm® topical silicone gel and pressure garment therapy. Participants will include 135 children (45 per group) up to 16 years of age who are referred for scar management for a new burn. Children up to 18 years of age will also be recruited following surgery for burn scar reconstruction. Primary outcomes are scar itch intensity and scar thickness. Secondary outcomes include scar characteristics (e.g. colour, pigmentation, pliability, pain), the patient's, caregiver's and therapist's overall opinion of the scar, health service costs, adherence, health-related quality of life, treatment satisfaction and adverse effects. Measures will be completed on up to two sites per person at baseline and 1 week post scar management commencement, 3 months and 6 months post burn, or post burn scar reconstruction. Data will be analysed using descriptive statistics and univariate and multivariate regression analyses.

DISCUSSION

Results of this study will determine the effectiveness of three noninvasive scar interventions in children at risk of, and with, scarring post burn or post reconstruction.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry, ACTRN12616001100482 . Registered on 5 August 2016.

摘要

背景

烧伤后异常瘢痕形成会给儿童及其家庭带来极大的身心痛苦。常见的烧伤瘢痕预防和治疗技术包括硅胶疗法、压力衣疗法或两者结合。目前,对于局部硅胶凝胶或压力衣疗法在预防和治疗儿童烧伤瘢痕方面的有效性,尚无确凿的高质量证据。因此,本研究旨在确定这些治疗方法对儿童的有效性。

方法

将在澳大利亚一家大型三级城市儿童医院进行一项随机对照试验。参与者将被随机分为三组之一:仅使用Strataderm®局部硅胶凝胶、仅使用压力衣疗法或联合使用Strataderm®局部硅胶凝胶和压力衣疗法。参与者将包括135名16岁及以下因新烧伤而被转诊进行瘢痕管理的儿童(每组45名)。18岁及以下接受烧伤瘢痕重建手术的儿童也将被招募。主要结局指标是瘢痕瘙痒强度和瘢痕厚度。次要结局指标包括瘢痕特征(如颜色、色素沉着、柔韧性、疼痛)、患者、照顾者和治疗师对瘢痕的总体评价、医疗服务成本、依从性、健康相关生活质量、治疗满意度和不良反应。将在基线时以及瘢痕管理开始后1周、烧伤后3个月和6个月或烧伤瘢痕重建后,每人最多在两个部位进行测量。数据将使用描述性统计以及单变量和多变量回归分析进行分析。

讨论

本研究结果将确定三种非侵入性瘢痕干预措施对有烧伤后或重建后瘢痕形成风险以及已有瘢痕的儿童的有效性。

试验注册

澳大利亚新西兰临床试验注册中心,ACTRN12616001100482。于2016年8月5日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8884/5314463/b89fb1ccac19/13063_2017_1820_Fig1_HTML.jpg

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