The Royal Children's Hospital, Department of Plastic and Maxillofacial Surgery, Murdoch Childrens Research Institute and the Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
The Royal Children's Hospital, Department of General Medicine, Murdoch Childrens Research Institute and Department of Paediatrics, Monash University, Clayton, Victoria Australia.
Int Wound J. 2017 Dec;14(6):967-972. doi: 10.1111/iwj.12740. Epub 2017 Mar 1.
Haemangioma of infancy, a benign tumour of blood vessels, is the most common tumour of infancy. Ulceration, the most common complication, presents a unique wound care challenge. A retrospective audit of medical records of children with haemangioma of infancy who presented to the Royal Children's Hospital, Melbourne, Australia, between January 2000 and December 2014 was undertaken with an aim to examine wound management of ulcerated haemangioma of infancy. In total, 535 hospital medical records were identified as suitable, of which 352 were randomly selected and audited, of which 84 patients had ulcerated haemangioma of infancy, and 62 were subject to wound management. Of these, 35 were successfully managed by wound dressings, 9 were not fully healed at the time of last review, and 18 were referred for surgical excision. Patients attended an average of five outpatient visits, and the average time from presentation to documented healing was 105 days. There were a total of 225 episodes of wound dressing, for which there was a documented follow-up appointment at which healing could be assessed. Although a wide range of dressings were used, there was no clear pattern of benefit of one dressing over another. Wounds were less likely to be healed after the use of a silver-impregnated dressing. Pain was poorly documented. Clinical assessment of whether wounds were infected was of no help in planning treatment. There is considerable variability in the management of this difficult wound group, and further prospective studies are required.
婴幼儿血管瘤是一种良性血管肿瘤，是婴幼儿最常见的肿瘤。溃疡是最常见的并发症，给伤口护理带来了独特的挑战。本研究对 2000 年 1 月至 2014 年 12 月期间在澳大利亚墨尔本皇家儿童医院就诊的婴幼儿血管瘤患儿的病历进行了回顾性审核，旨在研究溃疡型婴幼儿血管瘤的伤口管理。共确定了 535 份医院病历符合条件，其中随机抽取了 352 份病历进行审核，其中 84 例患儿患有溃疡型婴幼儿血管瘤，62 例接受了伤口管理。其中，35 例经伤口敷料治疗成功，9 例在最后一次复查时未完全愈合，18 例转外科切除。患者平均就诊 5 次，从就诊到记录愈合的平均时间为 105 天。共使用了 225 次伤口敷料，有记录的随访时间可以评估愈合情况。虽然使用了多种敷料，但没有一种敷料明显优于另一种敷料。使用含银敷料后，伤口愈合的可能性降低。疼痛记录不佳。临床评估伤口是否感染无助于治疗计划。这种棘手的伤口处理方式存在很大的差异，需要进一步的前瞻性研究。
