Macfie J, McMahon M J
Br J Surg. 1980 Feb;67(2):85-9. doi: 10.1002/bjs.1800670205.
In an attempt to improve the management of the perineal wound after abdominoperineal excision of the rectum we have assessed the value of foam elastomer, a catalysed silicone polymer dressing. The substance has already been used successfully in the treatment of open, granulating wounds at other sites (1). On the fourteenth postoperative day 50 patients with open perineal wounds were randomized to receive either conventional gauze packing or treatment with a foam elastomer dressing. Patients were received weekly until healing occurred. When no cavity remained, a dry dressing alone was used. Initial wound volume was calculated in all patients by forming a foam dressing the volume of which was measured by displacement of water. Healing times were shorter in patients who received foam elastomer, but not significantly so. However, less analgesia (P less than 0.01) and fewer district nurse visits (P less than 0.001) were required by patients in the foam elastomer group. This study suggests that foam elastomer dressing is a more comfortable alternative to a gauze pack in the management of the perineal wound and substantially reduces the amount of nursing supervision which is required. We recommend its routine use in the management of the open perineal wound particularly in the young and cooperative patient.
为了改善直肠癌腹会阴联合切除术后会阴伤口的处理，我们评估了泡沫弹性体（一种催化硅酮聚合物敷料）的价值。该物质已成功用于治疗其他部位的开放性肉芽伤口（1）。术后第14天，50例会阴开放性伤口患者被随机分为接受传统纱布填塞或泡沫弹性体敷料治疗两组。每周对患者进行检查，直至伤口愈合。当伤口没有腔隙残留时，仅使用干敷料。通过制作一个泡沫敷料，测量其排出水的体积，从而计算出所有患者最初的伤口体积。接受泡沫弹性体治疗的患者愈合时间较短，但差异无统计学意义。然而，泡沫弹性体组患者所需的镇痛药物较少（P<0.01），地区护士的访视次数也较少（P<0.001）。本研究表明，在会阴伤口处理中，泡沫弹性体敷料比纱布填塞更舒适，并且大大减少了所需的护理监督量。我们建议在开放性会阴伤口处理中常规使用，特别是对于年轻且配合的患者。
