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对皮肤移植供区进行高压电刺激可加速愈合过程。一项随机双盲临床试验。

High-voltage electric stimulation of the donor site of skin grafts accelerates the healing process. A randomized blinded clinical trial.

作者信息

Gomes Rosana C, Guirro Elaine C O, Gonçalves Adriana C, Farina Junior Jayme A, Murta Junior Luiz O, Guirro Rinaldo R J

机构信息

Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil.

Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil; Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil.

出版信息

Burns. 2018 May;44(3):636-645. doi: 10.1016/j.burns.2017.10.006.

Abstract

INTRODUCTION

Severe burns benefit from skin grafting, and grafting surgery is of great importance in the treatment of these injuries. As a result, there is formation of an additional wound at the donor site, which is painful and susceptible to infection. However, the therapeutic approach to these problems at donor sites for skin grafting is insufficiently explored in the literature.

AIM

To evaluate electrical stimulation of the donor sites of burn patients treated by grafting surgery.

METHODS

This work evaluated 30 donor sites of cutaneous graft burn patients treated with high-voltage electrical stimulation. Subjects were randomized into two groups: electrical stimulation (GES), treated with electrostimulation (50min, 100Hz, twin pulses 15 us, monophasic), and the sham group (GS), treated by the same procedures but without current. Pain was assessed by visual analog scale daily before and after the electrical stimulation. The time elapsed until complete epithelization was evaluated (time of primary dressing detached spontaneously). Skin temperature was measured by thermography. The characteristics of donor sites were qualitatively evaluated using images and the plug-in CaPAS (Carotid Plaque Analysis Software).

RESULTS

The results showed a significant decrease in pain, which was absent on the third day in the GES and the sixth day in the GS. The time the primary dressing detached spontaneously in days decreased (p<0.05) (4.7±0.2) compared to the GS group (7.0±1.3). Donor site healing characteristics such as vascularization, pigmentation, height, the quantity of crust formed, irregularities, and the quality of healing was better in the GES; moreover, homogeneity and inertia of the images confirmed higher healing quality.

CONCLUSION

As a result of the study, the technology shows promise and merits a larger study with objective assessments and different physical variables.

摘要

引言

严重烧伤患者可通过皮肤移植获益,移植手术在这些损伤的治疗中具有重要意义。因此,供皮区会形成额外的伤口,该伤口疼痛且易感染。然而,关于皮肤移植供皮区这些问题的治疗方法,文献中探讨不足。

目的

评估对接受移植手术治疗的烧伤患者供皮区进行电刺激的效果。

方法

本研究对30例接受高压电刺激治疗的皮肤移植烧伤患者的供皮区进行了评估。受试者被随机分为两组:电刺激组(GES),接受电刺激治疗(50分钟,100赫兹,双脉冲15微秒,单相);假手术组(GS),采用相同步骤但不通电。每天在电刺激前后通过视觉模拟量表评估疼痛程度。评估直至完全上皮化的时间(初次敷料自然脱落的时间)。通过热成像测量皮肤温度。使用图像和插件CaPAS(颈动脉斑块分析软件)对供皮区特征进行定性评估。

结果

结果显示疼痛显著减轻,GES组第三天疼痛消失,GS组第六天疼痛消失。与GS组(7.0±1.3)相比,初次敷料自然脱落的天数减少(p<0.05)(4.7±0.2)。GES组供皮区的愈合特征,如血管化、色素沉着、高度、结痂量、不规则性及愈合质量更好;此外,图像的均匀性和稳定性证实愈合质量更高。

结论

研究结果表明,该技术具有前景,值得进行更大规模的研究,采用客观评估方法并纳入不同的物理变量。

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