Department of Plastic and Reconstructive Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Plastic and Reconstructive Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Burns. 2019 Dec;45(8):1888-1894. doi: 10.1016/j.burns.2019.07.019. Epub 2019 Aug 2.
This study was carried out to compare the efficacy of silver nanoparticle gel (SG), nanosilver foam (SF) and collagen (C) dressings in partial thickness burn wounds.
This was a single-center, prospective cohort study carried out over a period of 1 year on patients with 15-40% partial thickness thermal burns ≤48 h. Each patient received all three dressings (silver-nanoparticle gel, nanosilver foam, collagen) simultaneously at 3 randomly selected areas which were comparable in terms of burn depth and surface area. Efficacy of the dressings was assessed in terms of healing rates, time taken and ease of application, pain at dressing change, cost, wound-swab culture and scar quality (at 3 months).
A total of 20 patients were included. In SF group, number of patients with 60%-80% re-epithelialization on day10 (SG: 10/20; C: 10/20; SF: 16/20; p = 0.042) and complete healing on day14 (SF: 11/20, C: 6/20, SG: 4/20; p = 0.032) was significantly higher. The time for dressing change was similar at admission (p = 0.918) and day 10 (p = 0.163), although majority of the patients in SF group needed less than 10 min. The time taken (<10 min) was significantly lower in SF group by 14th day (SF: 18/20 C: 6/20 SG: 6/20; p < 0.001). The ease of application rated by clinicians as "extremely easy" was significantly better in SF group (SG: 78%, C: 80%, SF: 95%; p = 0.011). There was a significantly faster decrease in pain scores in SF group by 5th day (VAS score SF: 6, C: 8; SG: 8; p = 0.038), however, pain scores were comparable at 2 weeks. The scar quality (p = 0.82), cost (p = 0.09) and infection rates (SG: 7/20; C: 4/20; SF: 3/20; p = 0.05) were comparable. The need for skin-graft cover was lower in SF group (SG: 5/20; C: 3/20; SF: 1/20).
Nanosilver-foam dressings were found to be more efficacious for re-epithelialization, healing, ease of application, tolerance when compared to silver nanoparticle gel and collagen dressings in partial-thickness burns. All were found to be safe.
本研究旨在比较纳米银凝胶（SG）、纳米银泡沫（SF）和胶原蛋白（C）敷料在部分厚度烧伤创面的疗效。
这是一项为期 1 年的单中心前瞻性队列研究，共纳入 15-40%部分厚度热烧伤≤48 小时的患者。每位患者同时在 3 个随机选择的区域使用所有 3 种敷料（银纳米凝胶、纳米银泡沫、胶原蛋白），这些区域在烧伤深度和面积方面具有可比性。通过愈合率、愈合时间、应用便利性、更换敷料时的疼痛、成本、创面拭子培养和 3 个月时的疤痕质量来评估敷料的疗效。
共纳入 20 例患者。SF 组中，第 10 天有 60%-80%再上皮化的患者人数（SG：20/20；C：20/20；SF：16/20；p=0.042）和第 14 天完全愈合的患者人数（SF：20/20，C：6/20，SG：4/20；p=0.032）明显更高。入院时（p=0.918）和第 10 天（p=0.163）更换敷料的时间相似，尽管 SF 组中大多数患者需要的时间不到 10 分钟。第 14 天，SF 组更换敷料的时间明显缩短（SF：20/20，C：6/20，SG：6/20；p<0.001）。SF 组的临床医生评估为“非常容易”的应用便利性明显更好（SG：78%，C：80%，SF：95%；p=0.011）。SF 组第 5 天疼痛评分明显下降（VAS 评分 SF：6，C：8；SG：8；p=0.038），然而，2 周时疼痛评分相似。疤痕质量（p=0.82）、成本（p=0.09）和感染率（SG：20/20；C：4/20；SF：3/20；p=0.05）相似。SF 组需要皮肤移植覆盖的患者较少（SG：20/20；C：3/20；SF：1/20）。
与纳米银凝胶和胶原蛋白敷料相比，纳米银泡沫敷料在部分厚度烧伤的再上皮化、愈合、应用便利性、耐受性方面被发现更有效。所有这些敷料都被认为是安全的。
