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评估藻酸盐敷料在烧伤创面及烧伤手术相关供皮区创面处理中的治疗效果和安全性:当代随机对照试验的系统评价和荟萃分析。

Evaluating the therapeutic efficacy and safety of alginate-based dressings in burn wound and donor site wound management associated with burn surgery: a systematic review and meta-analysis of contemporary randomized controlled trials.

作者信息

Lou Jiaqi, Xiang Ziyi, Zhu Xiaoyu, Song Jingyao, Huang Neng, Li Jiliang, Jin Guoying, Cui Shengyong, Xu Pei, Le Xin, Fan Youfen, Xu Sida

机构信息

Burn Department, Ningbo No. 2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, 315010, Zhejiang Province, China.

Institute of Pathology, Faculty of Medicine, University of Bonn, 53127, Bonn, Germany.

出版信息

BMC Surg. 2025 May 16;25(1):215. doi: 10.1186/s12893-025-02956-z.

Abstract

BACKGROUND

Alginate-based dressings are widely used in burn care for their absorptive and healing properties; however, inconsistencies in clinical outcomes remain.

METHODS

This study followed the PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) comparing alginate dressings to other treatments in burn patients and their donor sites. Inclusion criteria focused on prospective trials with measured outcomes such as healing time, pain scores, dressing change frequency, and adverse events. Data extraction and quality assessment adhered to standardized methods, and meta-analyses were performed using R 4.4.2 and Stata 15.0 with the GRADE approach to evaluate evidence certainty. Data were aggregated and reported as relative risk (RR), mean difference (MD) and standardized mean difference (SMD), with a 95% confidence interval (CI).

RESULTS

Fifteen studies met the inclusion criteria. The meta-analysis revealed a significantly shorter healing time with alginate dressings versus controls, showing a MD of -1.09 days (95% CI: -1.67 to -0.31, p < 0.001, I = 94.6%). Pain scores also favored alginate dressings, with a SMD of -1.37 (95% CI: -2.53 to -0.21, p = 0.000, I = 90.9%). There was no significant difference in dressing change frequency, with an SMD of 2.18 (95% CI: -4.29 to -0.07, p = 0.000, I = 94.0%). Adverse events showed a RR of 0.81 (95% CI: 0.50 to 1.30, p = 0.021, I = 51.1%), indicating similar safety profiles in both groups.

CONCLUSION

Our findings indicate that alginate dressings not only significantly reduce healing time but also offer clinically relevant benefits, including reduced pain and fewer dressing changes, making them a valuable option in burn wound management. However, their effect on dressing change frequency and adverse events remains comparable to control treatments. Despite the methodological limitations such as high heterogeneity and potential biases, alginate dressings maintain advantages in clinical settings. Standardization of evaluation criteria and long-term studies are necessary to enhance the understanding and application of alginate dressings in diverse burn wound and donor site wound care settings.

摘要

背景

藻酸盐敷料因其吸收性和促进愈合的特性而广泛应用于烧伤护理;然而,临床结果仍存在不一致性。

方法

本研究遵循PRISMA指南,系统检索了PubMed、Embase、Cochrane和Web of Science数据库,以查找比较藻酸盐敷料与其他治疗方法用于烧伤患者及其供皮区的随机对照试验(RCT)。纳入标准侧重于具有如愈合时间、疼痛评分、换药频率和不良事件等可测量结果的前瞻性试验。数据提取和质量评估遵循标准化方法,并使用R 4.4.2和Stata 15.0软件,采用GRADE方法进行荟萃分析以评估证据的确定性。数据汇总并报告为相对危险度(RR)、平均差(MD)和标准化平均差(SMD),并给出95%置信区间(CI)。

结果

15项研究符合纳入标准。荟萃分析显示,与对照组相比,藻酸盐敷料显著缩短了愈合时间,平均差为-1.09天(95%CI:-1.67至-0.31,p<0.001,I=94.6%)。疼痛评分也更有利于藻酸盐敷料,标准化平均差为-1.37(95%CI:-2.53至-0.21,p=0.000,I=90.9%)。换药频率无显著差异,标准化平均差为2.18(95%CI:-4.29至-0.07,p=0.000,I=94.0%)。不良事件的相对危险度为0.81(95%CI:0.50至1.30,p=0.021,I=51.1%),表明两组安全性相似。

结论

我们的研究结果表明,藻酸盐敷料不仅能显著缩短愈合时间,还具有临床相关益处,包括减轻疼痛和减少换药次数,使其成为烧伤创面处理中的一个有价值的选择。然而,其对换药频率和不良事件的影响与对照治疗相当。尽管存在如高异质性和潜在偏倚等方法学局限性,但藻酸盐敷料在临床环境中仍保持优势。有必要对评估标准进行标准化并开展长期研究,以加深对藻酸盐敷料在不同烧伤创面和供皮区创面护理中的理解和应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/641d/12083019/8de8a8cc1629/12893_2025_2956_Fig1_HTML.jpg

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