Aurora Amit, Beasy Alexander, Rizzo Julie A, Chung Kevin K
U.S. Army Institute of Surgical Research, JBSA, Fort Sam Houston, Texas.
Uniformed Services University of the Health Sciences, Bethesda, Maryl.
J Burn Care Res. 2018 Jun 13;39(4):593-597. doi: 10.1093/jbcr/irx026.
The military has used silver-nylon dressings as a topical antimicrobial on combat-related burns for the past 15 years. However, their clinical efficacy and associated risks have not been evaluated. Herein, the authors document our experience with the use of a specific silver-nylon dressing (Silverlon®) during global evacuation of casualties from combat zones to the United States sArmy Institute of Surgical Research Burn Center. A 10-year retrospective analysis was performed. Variables included patient demographics, total body surface area, length of stay, Injury Severity Score, incidence of urinary tract and burn infections, pneumonia, patient status at the time of discharge, and a composite endpoint. The patient cohort was stratified into two groups: Silverlon® (Group 1) and topical antimicrobial agents (Group 2). Data were analyzed using appropriate statistical tests (P ≤ .05). Nine hundred eighty-eight patients (26 ± 6 years) were identified with 184 patients (Group 1) and 804 patients (Group 2). Silver-nylon dressings trended toward decreased wound infection rate (5.4 vs 9.5%) even when applied to full-thickness burn injuries. When compared with topical antimicrobial agents, the silver-nylon dressing was not associated with significant differences in burn-related complication. The authors demonstrate the antimicrobial efficacy of the silver-nylon dressing during global evacuation of burn casualties from combat zones to the burn center. Compared with topical antimicrobials, the silver-nylon dressing is lightweight and easy to apply and requires minimal wound management which makes it desirable as a burn dressing for combat applications as well as mass casualty situations.
在过去15年里,军方一直将银尼龙敷料用作与战斗相关烧伤的局部抗菌剂。然而,其临床疗效和相关风险尚未得到评估。在此,作者记录了我们在将伤员从战区全球撤离至美国陆军外科研究所烧伤中心期间使用一种特定银尼龙敷料(Silverlon®)的经验。进行了一项为期10年的回顾性分析。变量包括患者人口统计学特征、全身表面积、住院时间、损伤严重程度评分、尿路感染和烧伤感染发生率、肺炎、出院时患者状况以及一个复合终点。患者队列分为两组:Silverlon®组(第1组)和局部抗菌剂组(第2组)。使用适当的统计检验进行数据分析(P≤0.05)。共识别出988例患者(26±6岁),其中184例患者(第1组),804例患者(第2组)。即使应用于全层烧伤创面,银尼龙敷料也有使伤口感染率降低的趋势(5.4%对9.5%)。与局部抗菌剂相比,银尼龙敷料与烧伤相关并发症无显著差异。作者证明了银尼龙敷料在将烧伤伤员从战区全球撤离至烧伤中心期间的抗菌效果。与局部抗菌剂相比,银尼龙敷料重量轻、易于应用,且伤口处理要求最低,这使其成为战斗应用以及大规模伤亡情况下理想的烧伤敷料。