Cussons David, Sullivan Justine, Frew Quentin, Barnes David
St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK.
Eur Burn J. 2024 Oct 17;5(4):335-345. doi: 10.3390/ebj5040031.
(1) Background: Effective wound management aims for expedited healing, improved functional and scar outcomes, and reduced complications including infection. Delayed wound healing remains a prevalent problem in the elderly. Suprathel is a synthetic absorbable skin substitute and an attractive option in partial thickness wounds. The objective of this randomised controlled study was to assess the effect of skin substitute dressings on elderly split-skin graft (STSG) donor sites, evaluating time to heal, pain, itch and scar outcome. (2) Methods: 40 patients over 65 undergoing split-thickness skin grafting for non-melanoma skin cancer excision were randomised to STSG donor site dressings with either Suprathel or Hypafix. Patients were followed up weekly until healed and at 13 weeks post-procedure. (3) Results: There was no significant difference in time to healing, pain, itch, or scar outcome at 13 weeks between the two groups. The mean time to healing was 31.7 days for the skin substitute group and 27.3 days for the adhesive tape control group ( = 0.182). (4) Conclusions: Both dressings are appropriate for STSG donor sites. Hypafix remains a cost-effective dressing of choice for donor sites. Benefits demonstrated in other studies using skin substitutes have not translated into the elderly population. There remains scope in developing dressings that reduce elderly donor site morbidity.
(1) 背景:有效的伤口管理旨在促进愈合、改善功能和瘢痕结局,并减少包括感染在内的并发症。伤口愈合延迟在老年人中仍然是一个普遍问题。Suprathel是一种合成可吸收皮肤替代物,是治疗部分厚度伤口的一个有吸引力的选择。这项随机对照研究的目的是评估皮肤替代敷料对老年分层皮片移植(STSG)供区的影响,评估愈合时间、疼痛、瘙痒和瘢痕结局。(2) 方法:40例65岁以上因非黑色素瘤皮肤癌切除而接受分层皮片移植的患者被随机分为使用Suprathel或Hypafix的STSG供区敷料组。每周对患者进行随访,直至伤口愈合,并在术后13周进行随访。(3) 结果:两组在愈合时间、疼痛、瘙痒或13周时的瘢痕结局方面没有显著差异。皮肤替代物组的平均愈合时间为31.7天,胶带对照组为27.3天(P = 0.182)。(4) 结论:两种敷料都适用于STSG供区。Hypafix仍然是供区具有成本效益的首选敷料。在其他使用皮肤替代物的研究中所显示的益处并未在老年人群中得到体现。在开发减少老年供区发病率的敷料方面仍有空间。