Maurer Kristina, Renkert Miriam, Duis Malte, Weiss Christel, Wessel Lucas M, Lange Bettina
Medical Faculty Mannheim, Heidelberg University, University Medical Center Mannheim, Department of Pediatric Surgery, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Medical Faculty Mannheim, Heidelberg University, University Medical Center Mannheim, Department of Pediatric Surgery, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Burns. 2022 May;48(3):608-614. doi: 10.1016/j.burns.2021.07.002. Epub 2021 Jul 13.
Management of pediatric thermal injuries involves a high standard of care in a multidisciplinary setting. To avoid physical and psychological sequelae, wound dressings should minimize hospitalization time and anesthesia while maximizing patient comfort.
190 children with thermal injuries of the torso, arms and legs were treated with polyurethane foam dressings or bacterial nanocellulose sheets. Data were analyzed retrospectively regarding hospitalization, procedures with general anesthesia, scar formation, rate of infection and need for skin grafting.
The groups did not differ significantly concerning age, gender distribution or percentage of injured total body surface area. Statistical analysis showed that length of hospitalized care and procedures undergoing anesthesia were significantly reduced in the nanocellulose group (each p < 0.0001). There was no significant difference in rate of complications, wound healing and rate of skin grafting between the two subgroups.
Acting as a temporary epidermal substitute, bacterial nanocellulose enables undisturbed reepithelialization without further wound dressing changes. In children, no additional topical antimicrobial agents are indicated for unimpaired wound healing.
Bacterial nanocellulose is superior to polyurethane foam regarding length of hospitalization and number of interventions under anesthesia. It offers a safe, cost-effective treatment option and provides excellent comfort in pediatric patients.
小儿热烧伤的治疗需要在多学科环境下提供高标准的护理。为避免身体和心理后遗症,伤口敷料应在缩短住院时间和减少麻醉的同时,最大程度地提高患者舒适度。
190例躯干、手臂和腿部热烧伤患儿接受了聚氨酯泡沫敷料或细菌纳米纤维素片治疗。对住院情况、全身麻醉手术、瘢痕形成、感染率和植皮需求等数据进行回顾性分析。
两组在年龄、性别分布或全身烧伤总面积百分比方面无显著差异。统计分析表明,纳米纤维素组的住院护理时长和接受麻醉的手术次数显著减少(均p < 0.0001)。两个亚组在并发症发生率、伤口愈合情况和植皮率方面无显著差异。
作为一种临时的表皮替代物,细菌纳米纤维素可实现不受干扰的再上皮化,无需进一步更换伤口敷料。对于儿童,在伤口愈合未受影响的情况下,无需额外使用局部抗菌剂。
在住院时长和麻醉下的干预次数方面,细菌纳米纤维素优于聚氨酯泡沫。它提供了一种安全、经济有效的治疗选择,并为儿科患者带来极佳的舒适度。