From the Johns Hopkins University School of Medicine.
private practice.
Plast Reconstr Surg. 2024 Dec 1;154(6):1233-1244. doi: 10.1097/PRS.0000000000011316. Epub 2024 Feb 7.
Silk fibroin is an emerging biomaterial with enhanced properties of cellular regeneration, growth, and proliferation. The use of a silk fibroin wound dressing has the potential to decrease the incidence of wound-healing complications and to improve patient outcomes compared with synthetic dressing alternatives.
A randomized, single-blind clinical trial was conducted on 50 patients who were dressed with a silk fibroin dressing on 1 side of their body and 3M Steri-Strips on the contralateral side after abdominoplasty, reduction mammaplasty, or brachioplasty procedures. Data were collected over 5 postoperative visits using photographs and an investigator-administered questionnaire to monitor erythema, skin irritation, skin discomfort, need for pharmaceutical intervention, wound dehiscence, and mechanical skin injury. A comprehensive 75-patient statistical analysis was conducted, combining the results with a previously published study comparing Dermabond Prineo with the silk dressing.
A total of 20.8% of patients (10 of 48) were assessed by surgeons as having skin erythema (7 to 10) on the Steri-Strip control side, with 0% (0 of 48) on the silk dressing side ( P = 0.002). The frequency of breast triple-point separation in 43 cases was 30.2% (13 of 43) on the Steri-Strip side and 9.3% (4 of 43) on the silk side ( P = 0.012). A total of 75% of patients (36 of 48) had partial or total detachment of Steri-Strips, 0% (0 of 48) had total detachment of the silk dressing, and 18.8% (9 of 48) had partial detachment of the silk dressing within the first 2 weeks ( P < 0.001).
A silk fibroin wound dressing significantly reduces the incidence of wound-healing complications throughout the postoperative period.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
The adoption of a silk fibroin wound dressing into clinical practice has the potential to improve patient outcomes, decrease medical adhesive-related skin injuries, and reduce the rate of wound-healing complications.
丝素蛋白是一种新兴的生物材料，具有增强细胞再生、生长和增殖的特性。与合成敷料替代品相比，使用丝素蛋白伤口敷料有可能降低伤口愈合并发症的发生率并改善患者的预后。
对 50 名接受腹部整形术、乳房缩小术或臂部成形术的患者进行了一项随机、单盲临床试验，在他们身体的一侧使用丝素蛋白敷料，另一侧使用 3M Steri-Strips。在术后 5 次就诊期间使用照片和研究者管理的问卷收集数据，以监测红斑、皮肤刺激、皮肤不适、需要药物干预、伤口裂开和机械性皮肤损伤。对总共 75 例患者进行了综合统计分析，将结果与之前一项比较 Dermabond Prineo 与丝素敷料的研究相结合。
共有 20.8%（48 例中的 10 例）的患者被外科医生评估为 Steri-Strip 对照侧有皮肤红斑（7 至 10），而丝素敷料侧为 0%（48 例中 0 例）（ P = 0.002）。在 43 例中，乳房三点分离的频率在 Steri-Strip 侧为 30.2%（13 例），在丝素侧为 9.3%（4 例）（ P = 0.012）。共有 75%（48 例中的 36 例）的患者有 Steri-Strip 的部分或完全脱落，0%（48 例中的 0 例）的丝素敷料完全脱落，18.8%（48 例中的 9 例）的丝素敷料在头 2 周内部分脱落（ P < 0.001）。
丝素蛋白伤口敷料在整个术后期间显著降低了伤口愈合并发症的发生率。
临床问题/证据水平：治疗性，II 级。
将丝素蛋白伤口敷料纳入临床实践有可能改善患者的预后，减少与医用胶粘剂相关的皮肤损伤，并降低伤口愈合并发症的发生率。
