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腹部手术后,闭塞性敷料和传统纱布敷料对切口愈合的影响。

Effects of occlusive and conventional gauze dressings on incisional healing after abdominal operations.

作者信息

Holm C, Petersen J S, Grønboek F, Gottrup F

机构信息

Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.

出版信息

Eur J Surg. 1998 Mar;164(3):179-83. doi: 10.1080/110241598750004616.

Abstract

OBJECTIVE

To compare the effect of occlusive (Comfeel) and conventional (Mepore) dressings on the healing of incisional wounds after abdominal operations.

DESIGN

Prospective randomised study.

SETTING

Laboratory and teaching hospital, Denmark.

SUBJECTS

73 patients who underwent clean operations requiring incisions longer than 5 cm between August 1993 and August 1995 were randomised to have their wounds dressed with either Comfeel or Mepore.

INTERVENTIONS

Comfeel was left on until the sutures were removed, and Mepore was removed 2 days postoperatively.

MAIN OUTCOME MEASURES

Infection, adherence, leakage, and cosmetic appearance three months later.

RESULTS

36 patients were randomised to have Comfeel and 37 to have Mepore. 29 patients were withdrawn from the study (20 having Mepore and 9 having Comfeel) leaving 26, and 17 for analysis, respectively. Wound infections developed in 1 patient in the Comfeel group and 5 in the Mepores group (p = 0.2). There were no differences between the groups regarding the need for dressings to be changed, the incidence of leakage, or loosening of the dressing from the skin. Comfeel adhered securely to the skin and remained more or less transparent until sutures were removed. It remained totally transparent in 23 (64%), and no dressing became totally opaque. There were no differences in cosmetic appearance after three months. We had the impression that patients who had Comfeel were more comfortable and found it easier to mobilise and carry out their daily activities.

CONCLUSION

Occlusive dressings stay in place and stay transparent, and do not increase the risk of wound infection. They may even be more comfortable. they are a reasonable alternative to conventional dressings.

摘要

目的

比较封闭性(康惠尔)敷料和传统(美皮康)敷料对腹部手术后切口愈合的影响。

设计

前瞻性随机研究。

地点

丹麦的实验室和教学医院。

研究对象

1993年8月至1995年8月间接受清洁手术且切口长度超过5厘米的73例患者,随机分为两组,分别使用康惠尔或美皮康敷料包扎伤口。

干预措施

康惠尔敷料一直保留至拆线,美皮康敷料术后2天拆除。

主要观察指标

3个月后的感染情况、粘连情况、渗液情况及美观程度。

结果

36例患者随机分配使用康惠尔敷料,37例使用美皮康敷料。29例患者退出研究(20例使用美皮康敷料,9例使用康惠尔敷料),分别剩余26例和17例用于分析。康惠尔组有1例患者发生伤口感染,美皮康组有5例(p = 0.2)。两组在更换敷料的必要性、渗液发生率或敷料与皮肤分离情况方面无差异。康惠尔敷料牢固地粘附于皮肤,在拆线前基本保持透明。23例(64%)完全保持透明,无敷料完全变不透明。3个月后美观程度无差异。我们感觉使用康惠尔敷料的患者更舒适,活动及日常活动更容易。

结论

封闭性敷料固定良好且保持透明,不会增加伤口感染风险。甚至可能更舒适。是传统敷料的合理替代物。

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