Kenworthy Pippa, Grisbrook Tiffany L, Phillips Michael, Gittings Paul, Wood Fiona M, Gibson William, Edgar Dale W
State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Physiotherapy, University of Notre Dame, Fremantle, Western Australia, Australia.
Fiona Wood Foundation, Fiona Stanley Hospital, Perth, Western Australia, Australia; School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Burns. 2017 Dec;43(8):1725-1735. doi: 10.1016/j.burns.2017.04.022. Epub 2017 Aug 7.
The control of edema in burn injured patients is a priority as it can impede the wound healing process. Bioimpedance spectroscopy (BIS) has been identified as a method of swelling assessment that has merit after burns. The aim of this study was to examine the reliability and validity of BIS in the measurement of localised burn wound edema across (1) different dressing conditions (no dressing, non silver and silver dressings) and (2) three electrode positions. BIS resistance (R) was hypothesised to be inversely proportional to fluid (edema) volume. BIS was collected in triplicate for all conditions of interest. BIS repeated measures demonstrated excellent concordance for all BIS resistance variables (R, R, R) (intraclass correlation coefficient=0.999-1.00, 95% confidence intervals 0.999-1.00) without a systematic difference. Multilevel mixed effects linear regression analysis examined the effect of electrode position and dressing condition on BIS resistance variables. R, R and R significantly increased with decreasing localised limb segment volume (p≤0.01). Resistance was significantly (1) reduced when a silver dressing was in situ (p<0.01) and (2) increased when a non-silver dressing was insitu (p<0.01). There was a significant interaction between each dressing condition and localised limb segment volume (p<0.01). An algorithm was developed to adjust resistance values when a silver dressing is in use. BIS may be used clinically to monitor localised changes in burn wound edema.
控制烧伤患者的水肿是首要任务,因为它会阻碍伤口愈合过程。生物电阻抗光谱法(BIS)已被确定为一种烧伤后具有价值的肿胀评估方法。本研究的目的是检验BIS在测量局部烧伤创面水肿时的可靠性和有效性,具体涉及(1)不同的敷料情况(不使用敷料、非银敷料和银敷料)以及(2)三个电极位置。假设BIS电阻(R)与液体(水肿)体积成反比。在所有感兴趣的条件下,BIS均重复测量三次。BIS重复测量结果显示,所有BIS电阻变量(R、R、R)具有极佳的一致性(组内相关系数=0.999 - 1.00,95%置信区间0.999 - 1.00),且无系统差异。多水平混合效应线性回归分析检验了电极位置和敷料情况对BIS电阻变量的影响。随着局部肢体节段体积减小,R、R和R显著增加(p≤0.01)。当使用银敷料时,电阻显著降低(p<0.01);当使用非银敷料时,电阻显著增加(p<0.01)。每种敷料情况与局部肢体节段体积之间存在显著交互作用(p<0.01)。开发了一种算法,用于在使用银敷料时调整电阻值。BIS可在临床上用于监测烧伤创面水肿的局部变化。