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与石蜡纱布和磺胺嘧啶银相比,胶原蛋白片敷料治疗浅Ⅱ度烧伤的疗效观察

Management Of Superficial Partial Thickness Burn With Collagen Sheet Dressing Compared With Paraffin Gauze And Silver Sulfadiazine.

作者信息

Singh A, Bhatnagar A

机构信息

Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.

出版信息

Ann Burns Fire Disasters. 2020 Sep 30;33(3):233-238.

Abstract

Burn injury is a global problem that equally concerns under-developed and developing countries. An ideal dressing material has to maintain a moist environment, act as a bacterial barrier and as a medium for free exchange of gases, while providing a barrier against toxic contaminants. Sixty-eight consecutive patients with fresh acute superficial partial thickness burns ≤ 15% BSA, registered in two tertiary care teaching hospitals in North India between January 2015 to December 2019, were divided into two groups: a collagen dressing group (group A) and a paraffin gauze (PG) plus silver sulfadiazine (SSD) group (group B). Forty-four patients received collagen dressing and 24 patients received conventional paraffin gauze (PG) plus silver sulfadiazine (SSD) dressing. Patients were followed up for clinical outcome until burn wounds healed. We observed complete healing in 5-7 days for 26 cases (59%) in group A, in 8-12 days for 16 cases (66.66%) in group B. A total of 95.5% of group A patients required analgesia only for ≤ 2days, while 90.90% of group B patients required analgesia for ≥ 6 days. Ninety percent of group A patients required none or a single dressing change with shorter hospital stay. In group B, 22 cases required 3-5 dressing changes. Collagen dressing has proved to be highly advantageous for acute small areas of partial thickness burns (< 15% BSA). It confers better pain relief, and minimal or no dressing change with better rate of wound healing. Pediatric patients preferred collagen sheet dressing. Conventional dressings tend to adhere to the wound surface, and their need for frequent changes traumatises newly epithelialized surfaces and may delay healing.

摘要

烧伤是一个全球性问题,同样困扰着欠发达国家和发展中国家。理想的敷料必须保持湿润环境,充当细菌屏障和气体自由交换的介质,同时提供抵御有毒污染物的屏障。2015年1月至2019年12月期间,在印度北部的两家三级护理教学医院登记的68例新鲜急性浅表性部分厚度烧伤且烧伤面积≤15%体表面积(BSA)的连续患者被分为两组:胶原敷料组(A组)和石蜡纱布(PG)加磺胺嘧啶银(SSD)组(B组)。44例患者接受胶原敷料,24例患者接受传统石蜡纱布(PG)加磺胺嘧啶银(SSD)敷料。对患者进行随访直至烧伤创面愈合以观察临床结果。我们观察到,A组26例患者(59%)在5 - 7天内完全愈合,B组16例患者(66.66%)在8 - 12天内完全愈合。A组共有95.5%的患者仅需≤2天的镇痛,而B组90.90%的患者需要≥6天的镇痛。A组90%的患者无需或仅需更换一次敷料,住院时间较短。在B组中,22例患者需要更换3 - 5次敷料。胶原敷料已被证明对急性小面积部分厚度烧伤(<15% BSA)非常有利。它能更好地缓解疼痛,换药最少或无需换药,伤口愈合率更高。儿科患者更喜欢胶原片敷料。传统敷料往往会粘附在创面,频繁更换会损伤新上皮化的创面,可能会延迟愈合。

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