Sankar Jhuma, Lalitha A V, Rameshkumar Ramachandran, Mahadevan Subramanian, Kabra Sushil K, Lodha Rakesh
Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Division of Pediatric Critical Care, Department of Pediatrics, St. Johns Medical College, Bengaluru, India.
Pediatr Crit Care Med. 2021 Jun 1;22(6):e349-e362. doi: 10.1097/PCC.0000000000002611.
To examine if the use of honey (medicated) for dressing is superior to standard care in terms of time to complete wound healing in stages 1-3 of pressure injuries in children admitted to the PICU.
Multicenter, open-label, parallel-group, randomized trial.
Tertiary-care PICU from August 2017 to January 2019.
Critically ill children, 2 months to 17 years old, who developed pressure injury (stages 1-3) were included; those on more than two inotropes or with signs of acute wound infection or wounds with greater than 5 cm diameter or known allergy to honey were excluded.
Children were randomized to receive either medicated honey dressing or standard (routine) wound care for the management of their pressure injury.
The primary outcome was the time to complete wound healing. Manuka or active Leptospermum honey dressing/gel was used in the intervention group. Enrolled children were followed up until death or discharge from the hospital. A total of 99 children were enrolled: 51 in the intervention group and 48 in the standard care group. Baseline characteristics, including the nutritional status, were comparable between the groups. The most common sites of injury were bony prominences at face mask contact points. The median time to complete healing was 7 days (95% CI, 6-7 d) versus 9 days (7-10 d) in the intervention and standard care groups, respectively (p = 0.002; log-rank test). At any random time, children in the intervention group were about 1.9-fold more likely to have their pressure injury completely healed than those in the standard care group (hazard ratio 1.86; 95% CI, 1.21-2.87). There were no allergic reactions or secondary wound infections in the intervention group.
The use of medicated honey dressings decreased the time to wound healing in critically ill children with pressure injuries. There were no allergic reactions or secondary bacterial infections in any of these children.
探讨在入住儿科重症监护病房（PICU）的儿童1 - 3期压力性损伤中，使用蜂蜜（含药）敷料进行伤口处理在促进伤口完全愈合时间方面是否优于标准护理。
多中心、开放标签、平行组随机试验。
2017年8月至2019年1月的三级护理PICU。
纳入2个月至17岁发生压力性损伤（1 - 3期）的危重症儿童；排除使用两种以上血管活性药物、有急性伤口感染迹象、伤口直径大于5 cm或已知对蜂蜜过敏的儿童。
将儿童随机分为接受含药蜂蜜敷料或标准（常规）伤口护理来处理其压力性损伤。
主要结局为伤口完全愈合时间。干预组使用麦卢卡蜂蜜或活性麦卢卡蜂蜜敷料/凝胶。对纳入儿童进行随访直至死亡或出院。共纳入99名儿童：干预组51名，标准护理组48名。两组间基线特征包括营养状况具有可比性。最常见的损伤部位是面罩接触点处的骨隆突。干预组和标准护理组伤口完全愈合的中位时间分别为7天（95%CI，6 - 7天）和9天（7 - 10天）（p = 0.002；对数秩检验）。在任何随机时间，干预组儿童压力性损伤完全愈合的可能性比标准护理组儿童高约1.9倍（风险比1.86；95%CI，1.21 - 2.87）。干预组未出现过敏反应或继发性伤口感染。
使用含药蜂蜜敷料可缩短危重症压力性损伤儿童的伤口愈合时间。这些儿童均未出现过敏反应或继发性细菌感染。
