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肝素冲洗在浅表烧伤处理中的作用,特别提及疼痛缓解和伤口愈合:一项初步研究。

Role of Heparin Irrigation in the Management of Superficial Burns with Special Reference to Pain Relief and Wound Healing: A Pilot Study.

作者信息

Vijayakumar Chellappa, Prabhu Ravi, Senthil Velan M, Muthu Krishnan Vallinayagam, Kalaiarasi Raja, T Swetha

机构信息

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

General Surgery, Sri Lakshmi Narayana Institute of Medical Science, Puducherry, IND.

出版信息

Cureus. 2018 Aug 17;10(8):e3157. doi: 10.7759/cureus.3157.

Abstract

Introduction The objective of this study was to assess the effect of heparin irrigation in the management of superficial first and second degree burns with special reference to pain relief and wound healing. Materials and methods This pilot study was carried out over a period of 12 months in a tertiary care centre in South India. The study patients were divided into two groups: the heparin group and the saline control group. In the control group, the burn wound was irrigated with 100 mL of normal saline before the conventional dressing with silver sulfadiazine. In the heparin irrigation group, the wound was irrigated with heparin solution before the conventional dressing. Wound healing was assessed in terms of necrotic tissue score and granulation tissue score. Patient satisfaction in terms of patient satisfaction score, visual analogue scale (VAS) score, and length of hospitalization were compared between the two groups. Results A total of 40 patients were analysed in the study, 20 patients in each group. Both the groups were comparable with respect to age, gender, co-morbidities, body mass index (BMI), and degree of burns. Wound healing parameters like necrotic tissue score of six [40% vs. 50%; p = 0.024] and granulation tissue score of four [85% vs. 65%; p= 0.06] were significant in the heparin group compared to the control group. However, the difference was not statistically significant. The mean length of hospitalization between the two groups [10.5 days vs. 12.6 days; p = 0.74] were not statistically significant. Similarly, there was no statistically significant difference between the two groups with respect to the VAS pain score on the seventh dressing day [6.9 vs. 7.3; p= 0.321]. Conclusion In comparison to saline irrigation, heparin irrigation would result in better wound healing in superficial first and second-degree burns. The length of hospital stay in days and VAS pain score on the seventh dressing day were not statistically significant between the two groups.

摘要

引言 本研究的目的是评估肝素冲洗在浅Ⅰ度和浅Ⅱ度烧伤处理中的效果,特别关注疼痛缓解和伤口愈合情况。

材料与方法 这项前瞻性研究在印度南部的一家三级护理中心进行,为期12个月。研究患者分为两组:肝素组和生理盐水对照组。对照组在使用磺胺嘧啶银进行常规换药前,用100 mL生理盐水冲洗烧伤创面。肝素冲洗组在常规换药前用肝素溶液冲洗创面。根据坏死组织评分和肉芽组织评分评估伤口愈合情况。比较两组患者的患者满意度评分、视觉模拟量表(VAS)评分和住院时间。

结果 本研究共分析了40例患者,每组20例。两组在年龄、性别、合并症、体重指数(BMI)和烧伤程度方面具有可比性。与对照组相比,肝素组的伤口愈合参数如坏死组织评分为6[40%对50%;p = 0.024]和肉芽组织评分为4[85%对65%;p = 0.06]有显著差异。然而,差异无统计学意义。两组的平均住院时间[10.5天对12.6天;p = 0.74]无统计学意义。同样,两组在第七次换药日的VAS疼痛评分方面也无统计学意义[6.9对7.3;p = 0.321]。

结论 与生理盐水冲洗相比,肝素冲洗可使浅Ⅰ度和浅Ⅱ度烧伤的伤口愈合更好。两组在住院天数和第七次换药日的VAS疼痛评分方面无统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82e2/6193569/c223d98b8904/cureus-0010-00000003157-i01.jpg

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