Harma Birsen, Gül Mehmet, Demircan Mehmet
Department of Pediatric Surgery, Pediatric Burn Unit, Turgut Özal Medical Center, Inönü University, Malatya, Turkey.
Department of Histology and Embryology, Faculty of Medicine, Inönü University, Malatya, Turkey.
J Burn Care Res. 2020 Nov 30;41(6):1179-1187. doi: 10.1093/jbcr/iraa063.
An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.
理想的敷料应确保伤口保持湿润并有渗出液，但不会发生浸渍。目前，尚无一种敷料能适用于愈合过程所有阶段的所有伤口。尽管含银敷料是烧伤创面护理的金标准，但很少有高级别试验完成以比较这些敷料的临床效用。在我们的研究中，比较了五种不同类型的伤口敷料：含离子银的羧甲基纤维素水凝胶敷料（CMCH-Ag）、含单质银的聚乙烯-聚对苯二甲酸乙二酯水凝胶敷料（PPAF-Ag）、海藻酸钙（CA）、钙+锌海藻酸盐（CZA）以及含0.2%呋喃西林的（NF）纱布敷料的组织病理学参数。本研究纳入了年龄在0至18岁之间、中小面积浅Ⅱ度烧伤且烧伤面积小于体表面积30%的儿童。研究组（CMCH-Ag、PPAF-Ag、CA和CZA）和对照组（NF）通过随机分组获得。在第21天通过打孔活检评估伤口愈合情况。计算并比较角质层和上皮的厚度、乳头数量以及乳头长度。除角质层厚度外，各研究组间愈合的组织学参数无统计学差异（P>0.05）。与仅含呋喃西林的敷料相比，含银、钙或锌的敷料在非感染性烧伤创面显示出有益且相似的效果。因此，可以得出结论，在儿童非感染性浅Ⅱ度烧伤创面，含银伤口敷料不应被视为金标准。
