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瘢痕按摩对烧伤瘢痕的影响:系统评价和荟萃分析。

Effects of scar massage on burn scars: A systematic review and meta-analysis.

机构信息

School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Nursing, Kaohsiung Medical University Hospital.

出版信息

J Clin Nurs. 2023 Jul;32(13-14):3144-3154. doi: 10.1111/jocn.16420. Epub 2022 Jun 27.

Abstract

AIMS AND OBJECTIVES

This study explored the physical and psychological effects of scar massage on burn patients.

BACKGROUND

Hypertrophic scar development is highly prevalent following burn injuries. Scar massage may have physical and psychological effects, although evidence of its effectiveness for burn scar improvement remains inconsistent.

DESIGN

A systematic review and meta-analysis of randomised controlled trials and quasi-experimental trials.

METHODS

This study was conducted following the Centre of Reviews and Dissemination guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PubMed, EMBASE, and Chinese Electronic Periodical Services were searched for studies published between January 1990 and February 2022. Quality was assessed using the Joanna Briggs Institute (JBI) Appraisal Checklist. The final recommendation strength was assessed according to the JBI recommendation rating. A meta-analysis was performed using Review Manager Version 5.4 software with a random-effect model.

RESULTS

Seven studies (420 participants) investigating scar massage for burn patients were included. The scar massage sessions lasted 5-30 min and were delivered by massage therapists 1-3 times a week for 12 weeks. Overall, scar massage decreased pain levels (standardised mean difference [SMD]: -2.39; 95% confidence interval [CI]: -3.96 to -0.83), improved scar thickness (mean difference: -0.05; 95% CI: -0.1 to -0.0), reduced pruritus (SMD: -1.89; 95% CI: -2.95 to -0.82) and reduced anxiety (SMD: -1.52; 95% CI: -2.73 to -0.32), but no significant effect on depression(SMD: -0.92; 95% CI:-2.28 to 0.44).

CONCLUSIONS

The meta-effects of scar massage among burn patients are significantly improved scar formation and reduced pruritus and anxiety. Providing scar massage is feasible and effective for burn patients. Future research should evaluate its long-term effects.

RELEVANCE TO CLINICAL PRACTICE

Scar massage is relatively convenient and effective in preventing and alleviating hypertrophic burn scarring. Further research can provide detailed suggestions for effective scar massage implementation.

摘要

目的和目标

本研究探讨了瘢痕按摩对烧伤患者的身心影响。

背景

烧伤后,增生性瘢痕的发生率很高。瘢痕按摩可能具有身心影响,但仍缺乏其对改善烧伤瘢痕效果的一致证据。

设计

对随机对照试验和准实验研究进行系统评价和荟萃分析。

方法

本研究遵循考科兰中心的评价和传播指南以及系统评价和荟萃分析的首选报告项目(PRISMA)声明。检索了 1990 年 1 月至 2022 年 2 月期间发表的 Cochrane 图书馆、Web of Science、护理学及相关健康领域累积索引、PubMed、EMBASE 和中国电子期刊服务的研究。使用 Joanna Briggs 研究所(JBI)评估清单评估质量。根据 JBI 推荐评级评估最终推荐强度。使用 Review Manager Version 5.4 软件采用随机效应模型进行荟萃分析。

结果

纳入了 7 项研究(420 名参与者),调查了烧伤患者的瘢痕按摩。瘢痕按摩疗程为 5-30 分钟,由按摩治疗师每周 1-3 次,持续 12 周。总体而言,瘢痕按摩降低了疼痛水平(标准化均数差 [SMD]:-2.39;95%置信区间 [CI]:-3.96 至 -0.83),改善了瘢痕厚度(平均差:-0.05;95%CI:-0.1 至 -0.0),减少了瘙痒(SMD:-1.89;95%CI:-2.95 至 -0.82)和焦虑(SMD:-1.52;95%CI:-2.73 至 -0.32),但对抑郁无显著影响(SMD:-0.92;95%CI:-2.28 至 0.44)。

结论

烧伤患者的瘢痕按摩的荟萃效应显著改善了瘢痕形成,减少了瘙痒和焦虑。为烧伤患者提供瘢痕按摩是可行且有效的。未来的研究应评估其长期效果。

临床相关性

瘢痕按摩在预防和缓解增生性烧伤瘢痕方面相对方便且有效。进一步的研究可以为有效的瘢痕按摩实施提供详细建议。

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