State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; The Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia; School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
The Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Burns. 2024 Aug;50(6):1605-1613. doi: 10.1016/j.burns.2024.03.024. Epub 2024 Mar 22.
Burns to the face and neck are a source of considerable distress and a challenge to manage with dressings. Further, these often superficial injuries pose a risk of scarring and altered pigmentation. Silicone gels have emerged as a potential solution to the challenges of conservative management for face and neck burn injuries. The aims of this study were to explore the effect of topical silicone compared to routine treatment of conservatively managed burns to the face and neck.
This single-blind, randomised, controlled trial compared topical silicone film-forming dressing to standard of care for superficial partial thickness burns to the face and neck. Time to healing was the primary outcome and secondary outcomes included: 1) scar assessments (modified Vancouver Scar Scale, Dermalab Combo and Patient and Observer Scar Assessment Scale) at six weeks and three months; and 2) pain intensity scale at wound review appointments.
Of the 55 participants in the face/neck study, 34 were male and 21 were female. Median age was 36 years (range from 25 to 47 years). The median time to healing for the silicone group was 9 days (CI 7.6 -10.4) and the control group was 7 days (CI 5.3- 8.7), p = 0.056. Analysis demonstrated significantly reduced pigmentation at six weeks in mVSS scores for the silicone group (Md = 0, IQR = 0) compared to the control group (Md = 0, IQR = 0 - 3), p = 0.043. We found no evidence of differences in reported pain between the groups (Silicone - Md = 1.15, IQR 0.3 - 4.5 vs control group - Md = 1.5, IQR 0.6 - 3.8, z = -0.63, p = 0.53). No other differences were observed, and no adverse events were associated with the topical silicone in the study whereas an infection and a reaction were experienced in the control group.
Film-forming silicone gel had comparable effects to standard of care emollient on wound healing of superficial partial thickness burns of the face and neck. Silicone treated wounds were associated with a significant improvement in scar pigmentation outcome at six weeks post-burn.
面部和颈部的烧伤是造成极大痛苦的根源，且敷料治疗具有挑战性。此外，这些通常是浅表性损伤会导致疤痕和色素改变的风险。硅酮凝胶已成为解决面部和颈部烧伤保守管理挑战的一种潜在方法。本研究的目的是探讨与面部和颈部浅表性部分厚度烧伤的常规保守治疗相比，局部硅酮的效果。
本单盲、随机、对照试验将局部硅酮成膜敷料与浅表性部分厚度烧伤的标准护理进行比较。愈合时间是主要结局，次要结局包括：1）在 6 周和 3 个月时进行疤痕评估（改良温哥华疤痕量表、Dermalab Combo 和患者和观察者疤痕评估量表）；2）伤口复查时的疼痛强度量表。
在面部/颈部研究的 55 名参与者中，34 名是男性，21 名是女性。中位年龄为 36 岁（范围 25 至 47 岁）。硅酮组的中位愈合时间为 9 天（CI 7.6-10.4），对照组为 7 天（CI 5.3-8.7），p=0.056。分析显示，在 mVSS 评分中，硅酮组在 6 周时的色素沉着显著减少（Md=0，IQR=0），而对照组（Md=0，IQR=0-3），p=0.043。我们没有发现两组之间报告的疼痛有差异（硅酮组 Md=1.15，IQR 0.3-4.5 vs 对照组 Md=1.5，IQR 0.6-3.8，z=-0.63，p=0.53）。没有观察到其他差异，且研究中局部硅酮无不良反应，而对照组发生了感染和反应。
成膜硅酮凝胶在面部和颈部浅表性部分厚度烧伤的愈合方面与标准护理软膏的效果相当。硅酮处理的伤口在烧伤后 6 周时疤痕色素沉着的结果有显著改善。
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