复方磺胺嘧啶锌涂膜剂联合促表皮生长因子治疗Ⅱ度烧伤临床观察

[目的]探讨复方磺胺嘧啶锌涂膜剂治疗Ⅱ度烧伤的疗效与不良反应。[方法]将65例Ⅱ度烧伤病人96处烧伤创面根据烧伤程度依纳入顺序按单双号均分入研究组和对照组,其中浅Ⅱ度烧伤创面每组35处,深Ⅱ度烧伤创面每组13处,研究组用复方磺胺嘧啶锌涂膜剂换药治疗,对照组用磺胺嘧啶银乳剂换药,观察每组病人创面愈合和细菌培养转阴情况。[结果]创面干燥时间、愈合时间、换药次数、分泌物细菌培养转阴率等项目研究组均优于对照组,差异有统计学意义（P〈0.05）。[结论]复方磺胺嘧啶锌涂膜剂用于Ⅱ度烧伤创面换药治疗,疗效优于磺胺嘧啶银乳剂且不良反应更少。     

磺胺嘧啶锌涂膜对Ⅱ°烧伤创面的影响

本文总结了复方磺胺嘧啶锌涂膜在８３例Ⅱ°烧伤创面的应用。方法：同期应用磺胺嘧啶银霜３２例作为对照,两组病人的平均年龄、性别、烧伤面积、深度无显著差异,用药方式均为暴露疗法。结果：复方磺胺嘧啶锌涂膜能够显著增加细菌转阴率和促进创面愈合,缩短愈合时间。结论：复方磺胺嘧锌涂膜是一种安全,可靠,理想的外用药物。对Ⅱ°烧（烫）伤创面可以替代磺胺嘧啶银霜的使用。     

复方磺胺嘧啶锌涂膜剂联合促表皮生长因子治疗Ⅱ度烧伤临床观察

[目的]探讨复方磺胺嘧啶锌涂膜剂治疗Ⅱ度烧伤的疗效与不良反应。[方法]将65例Ⅱ度烧伤病人96处烧伤创面根据烧伤程度依纳入顺序按单双号均分入研究组和对照组,其中浅Ⅱ度烧伤创面每组35处,深Ⅱ度烧伤创面每组13处,研究组用复方磺胺嘧啶锌涂膜剂换药治疗,对照组用磺胺嘧啶银乳剂换药,观察每组病人创面愈合和细菌培养转阴情况。[结果]创面干燥时间、愈合时间、换药次数、分泌物细菌培养转阴率等项目研究组均优于对照组,差异有统计学意义(P<0.05)。[结论]复方磺胺嘧啶锌涂膜剂用于Ⅱ度烧伤创面换药治疗,疗效优于磺胺嘧啶银乳剂且不良反应更少。     

复方磺胺嘧啶锌涂膜治疗浅Ⅲ度烧伤的护理体会

目的复方磺胺嘧啶锌涂膜治疗浅Ⅲ度烧伤的护理体会。对52例浅Ⅲ度烧伤住院患者全程规范运用复方磺胺嘧啶锌涂膜治疗，对深度创面进行早期减张处理；同时做好休克期、创面、基础护理、心理护理、营养支持等环节的护理．结果52例患者创面全部愈合，无一例植皮。创面愈合时间最短36天，最长80天，平均58天，均达到生理性愈合，无畸形，无功能障碍。结论浅Ⅲ度烧伤运用复方磺胺嘧啶锌涂膜治疗，配合合理正确的护理方法，可提高治愈率，促进创面再生修复．     

rhGM-CSF联合磺胺嘧啶银治疗深Ⅱ度烧烫伤创面的临床研究

[目的]探究重组人粒细胞巨噬细胞刺激因子(rhGM-CSF)联合磺胺嘧啶银治疗深Ⅱ度烧烫伤创面的疗效.[方法]筛选总面积小于10%的深Ⅱ度烧伤创面66例患者,按创面用药情况将患者分成磺胺嘧啶银组(对照组,n=33)和rhGM-CSF联合磺胺嘧啶银组(观察组,n=33),比较两组受试者的创面愈合率以及上皮化时间和治疗诱发的不良反应.[结果]观察组受试者的创面上皮化时间显著短于对照组,创面愈合率优于对照组;两组受试者在治疗期间均无不良反应(P<0.05).[结论]rhGM-CSF联合磺胺嘧啶银治疗深Ⅱ度烧烫伤患者其创面愈合更好,值得临床推广应用.     

自制复方紫草油治疗小儿浅Ⅱ度烧伤临床观察

目的:对自制复方紫草油治疗小儿浅Ⅱ度烧伤创面的疗效观察。方法:将60例热液烫伤致浅Ⅱ度烧伤小儿按随机分组为治疗组和对照组各30例,创面治疗分别用自制复方紫草油和复方磺胺嘧啶锌包扎疗法。观察2组创面用药反应及愈合情况、创面愈合时间、用药过程中是否出现创面局部刺激性疼痛、皮疹及局部过敏、创面加深等不良反应。结果:自制复方紫草油组创面愈合快于复方磺胺嘧啶锌组,创面用药时止痛效果好,上皮愈合质量好。换药操作时局部刺激小,未发现毒性反应、过敏表现和创面加深。结论:自制复方紫草油止痛效果好,换药时刺激小,患儿易于接受,疗效好,创面愈合时间快,用药安全。     

扶济复与磺胺嘧啶银联合用于烧伤创面的效果观察

目的探讨扶济复与磺胺嘧啶银联合用于烧伤创面的效果。方法将22例浅Ⅱ度烧伤患者和22例深Ⅱ度烧伤患者随机分为实验组和对照组。对照组22例,按常规方法消毒伤口周围、生理盐水清洗创面,再用庆大霉素纱布湿敷,无菌敷料包扎;实验组22例,亦按常规方法消毒伤口周围,用生理盐水清洗创面,然后用扶济复喷湿创面,再涂抹磺胺嘧啶银乳膏,对2组患者换药效果进行比较。结果与对照组比较,实验组患者愈合时间缩短,创面愈合率提高,差异有统计学意义(p<0.05)。结论扶济复与磺胺嘧啶银联合用于烧伤创面,能够提高伤口愈合率,缩短疗程,减轻患者痛苦,且操作简便,安全性高。     

纳米银与磺胺嘧啶银治疗烧伤创面疗效比较的Meta分析

背景:国内外应用纳米银治疗烧伤创面较为广泛,但临床研究报道多为小样本随机对照研究,缺乏循证医学方面的依据和说服力。目的:对纳米银与磺胺嘧啶银治疗烧伤创面疗效进行系统评价。方法:计算机检索PubMed、Sciencedirect(SD)数据库、重庆维普中文科技期刊全文数据库(VIP,1989/2010)和清华同方数据库(CNKI,1979/2010),收集有纳米银制剂治疗烧伤与磺胺嘧啶银治疗相比较的随机对照实验。评价纳入研究的方法学质量并进行资料提取后,采用RevMan5.1软件进行Meta分析。结果与结论:共纳入8个随机对照实验,包括513例Ⅱ度烧伤患者。Meta分析结果显示:创面愈合时间纳米银治疗组少于磺胺嘧啶银组(P<0.001);第15天创面愈合率纳米治疗组与对照组差异无显著性意义,结果为(MD=7.10,95%CI=-2.29~16.50,P=0.14);纳米银治疗组和磺胺嘧啶银组相比,在减少烧伤创面疼痛方面两者差异有显著性意义(P<0.00001)。提示应用纳米银与应用磺胺嘧啶银相比能明显促进烧伤创面的愈合,对缓解创面疼痛程度优势明显,但尚需大样本高质量随机对照研究去进一步证实。     

磺胺嘧啶银悬液与皮维碘治疗儿童烧伤的效果比较

目的 观察磺胺嘧啶银（SD－Ag)与皮维碘对儿童烧伤后减轻疼痛，防止瘢痕形成的疗效并进行效果分析。方法 将440例儿童烧伤随机分为2组，每组220例，治疗组外用20％ SD－Ag悬液，对照组外用10％皮维碘软膏，观察疼痛反应，平均愈合天数及功能恢复。结果 SD－Ag组用于浅Ⅱ度，深Ⅱ度早期在各项观察指标方面均优于皮维碘（P＜0．05）。结论 外用SD－Ag是儿童烧伤较为理想的方法。     

磺胺嘧啶银霜联合三黄油治疗浅Ⅱ度烧伤创面的效果观察

目的 探讨用磺胺嘧啶银霜和三黄油联合用药治疗浅Ⅱ度烧伤创面换药效果.方法 将120例浅Ⅱ度烧伤创面病人随机分为观察组和对照组各60例.观察组用磺胺嘧啶银霜和三黄油药物涂于创面,对照组仅用三黄油纱布湿敷创面.比较两组治愈时间.结果 观察组治愈时间明显短于对照组,差异有统计学意义(P＜0.01).结论 选用磺胺嘧啶银霜和三黄油联合用药疗效比单一使用三黄油效果显著,愈合时间短,换药次数少,减轻病人经济负担.     

Comparative evaluation of zinc sulfadiazine and silver sulfadiazine in burn wound infection

One percent silver sulfadiazine has been commonly used as a topical antimicrobial agent after a burn injury. Incidence of burn wound colonization by Staphylococcus aureus in patients treated with silver sulfadiazine has spurred research for other agents. A topical preparation that contains zinc and sulfadiazine (Zad-G) was evaluated for in vitro antibacterial spectrum and in vivo efficacy. Muscle biopsy specimens of rats treated with Zad-G appear to have fewer colonies of S. aureus than groups treated with silver sulfadiazine. Topical therapy with Zad-G for patients with burns was comfortable, reduced wound infection, and was comparable to therapy with silver sulfadiazine. A topical Zad-G preparation that contains zinc sulfadiazine appears to be an effective alternative to silver sulfadiazine in the treatment of burn wounds.     

早期应用辐照氟银猪皮对浅Ⅱ度烧伤创面愈合作用的临床研究

目的探讨早期应用辐照氟银猪皮对浅Ⅱ度烧伤创面的愈合作用。方法对20例大面积浅Ⅱ度烧伤患者早期应用辐照氟银猪皮治疗,观察其对创面愈合作用的影响。结果所有病例创面均顺利愈合,创面平均愈合时间为（9.2±1.2）d,且愈合后色素沉着、瘢痕少,无一例发生感染,平稳度过休克期,均无局部刺激症状和过敏反应,肝、肾功能,血常规检查指标均正常。结论早期应用辐照氟银猪皮治疗大面积浅Ⅱ度烧伤创面愈合快,最大限度地保留创面再生能力,给创面愈合提供了良好的内环境。同时患者病情平稳、疼痛轻、瘢痕少,提高了生活质量。     

磺胺嘧啶银脂质水胶敷料治疗重症天疱疮的效果观察及护理

目的 探讨磺胺嘧啶银脂质水胶敷料治疗重症天疱疮的效果,并总结护理要点,为临床提供一种有效的换药方法.方法 采用前后对照研究方法将2017年8月—2019年3月住院患者32例设为对照组,2019年4月—2020年8月住院患者28例设为试验组.对照组患者采用湿润烧伤膏油纱进行换药,每天1～2次;试验组患者采用磺胺嘧啶银脂质...     

A Randomized Controlled Trial of Silver Sulfadiazine, Biafine, and Saline-soaked Gauze in the Treatment of Superficial Partial-thickness Burn Wounds in Pigs

Silver sulfadiazine 1% cream (SSD) and biafine (an oil-in-water emulsion containing alginate) are used for the treatment of superficial partial-thickness burns, but comparative effectiveness studies are lacking. OBJECTIVES: To compare the uses of SSD, Biafine (Labortoires Medix, Houdan, France), and saline-soaked gauze in the treatment of superficial partial-thickness burns in pigs. METHODS: This was a randomized controlled trial in four anesthetized young pigs. Four equal sets of partial-thickness contact burns were inflicted on the pigs. Each burn was randomly assigned to treatment with biafine, SSD, or saline-soaked gauze with dressing changes every other day. Assessment of wound re-epithelialization was performed every other day, for a total of two weeks. The treatment groups were compared by univariable and multivariable analyses of variance (ANOVAs), controlling for the pig and the location of the burns on each pig. RESULTS: Thirty-two burns were inflicted on the pigs. Time to re-epithelialization of the burns was 13.5 days (SD +/- 0.9 days) in pigs treated with biafine, 13.3 days (+/-1.3 days) in pigs treated with SSD, and 13.5 days (+/-1.0 days) in pigs treated with saline-soaked gauze (p = not significant [NS]). The decreases in burn area from day 2 to day 12 were 21.4 cm(2) (+/-6.0 cm(2)) in pigs treated with biafine, 20.0 cm(2) (+/-6.3 cm(2)) in pigs treated with SSD, and 19.8 cm(2) (+/-5.9 cm(2)) in pigs treated with saline-soaked gauze (p = NS). A multivariable ANOVA showed a similar decrease in burn area between the treatment arms (p = NS) and a significant difference between the pigs (p = 0.015). CONCLUSION: Partial-thickness porcine burns treated with SSD, biafine, and soaked saline gauze re-epithelialize at similar rates.     

珍珠粉与复方磺胺嘧啶联合应用治疗糖尿病Ⅳ期压疮的效果观察

[目的]探讨珍珠粉与复方磺胺嘧啶联合应用治疗Ⅳ期压疮的效果。[方法]将40例糖尿病Ⅳ期压疮病人随机分为观察组和对照组。观察组采用珍珠粉与复方磺胺嘧啶粉混合喷于创面上。对照组采用3%过氧化氢溶液冲洗,1%皮维碘湿敷。观察两组病人压疮愈合情况。[结果]观察组治愈率高于对照组,差异有统计学意义（P〈0.05）。[结论]珍珠粉与复方磺胺嘧啶联合应用治疗Ⅳ期压疮效果明显,能减轻病人痛苦。     

A prospective, randomized trial of Acticoat versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful?

Despite recent improvements in analgesia, pain control during dressing changes continues to be a major challenge in patients with burns. We investigated two different dressing modalities to compare how much pain the patient experienced during and after the dressing change. Patients with partial-thickness burns that required only topical wound care were assigned randomly to treatment with Acticoat (Smith and Nephew USA, Largo, FL) or silver sulfadiazine (AgSD). The outcome variable was pain during wound care, which was measured using visual analog pain scores. The mean visual analog pain scores for the wounds treated with Acticoat or AgSD wounds were 3.2 and 7.9, respectively (P < .0001; paired Student's t-test). In 41 of the 47 paired pain score observations, the pain in the wound treated with AgSD was perceived as greater than in the wound treated with Acticoat. Burn wound care with Acticoat is less painful than burn wound care with AgSD in patients with selected partial-thickness burns.     

The Effects of Octylcyanoacrylate on Scarring after Burns

OBJECTIVE: To compare the effects of octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane film (PU), and dry gauze (G) on scarring three months after partial-thickness burns. METHODS: This was a prospective, blinded, controlled experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of a young pig for 20 seconds. Four equal sets of ten burns each were randomly treated with OCA spray, SSD, PU, or G. Dressing changes were performed on days 1, 2, 3, and 4 after injury. Digital images of the burns were obtained immediately and three months later for masked computerized determination of scar surface area. Full-thickness biopsies were taken at three months for masked histopathological evaluation. The primary outcome was the percent reduction in residual wound area (RWA) calculated by subtracting the area of each individual burn from the area of the largest burn and dividing this value by the area of the largest burn (intraobserver correlation, r = 0.99). Secondary outcomes were the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver agreement, kappa = 0.93) and the cosmetic appearance on a 100-mm visual analog scale marked "best scar" at the high end (inter-observer correlation, r = 0.82). Analysis of variance (ANOVA) and chi(2) tests were used for group comparisons as appropriate. This study had 80% power to detect a 33-percentage-point difference in RWA among groups (alpha = 0.05). RESULTS: A total of 40 burns were inflicted on the pig. There was no difference in percent RWA across the groups (OCA = 25%, SSD = 40%, PU = 25%, G = 32%; p = 0.13). There was no difference in the proportion of wounds with scarring among the groups (OCA = 10%, SSD = 22%, PU = 2%, G = 30%; p = 0.89). There was also no difference in the cosmetic scores among the groups (OCA = 78 mm, SSD = 75 mm, PU = 74 mm, G = 74 mm; p = 0.96). CONCLUSIONS: The effects of OCA spray, SSD, PU, and dry gauze on scarring three months after burns in pigs are similar.     

Cultured epidermal autograft and the treatment of the massive burn injury.

As a rule, adult and pediatric patients with thermal injuries that involve more than 90% total body surface area (TBSA) burn have poor prognoses. Even for patients who are 5 to 34 years old with a 70% TBSA burn, the mortality rate is 80%. Lack of autologous donor skin, which is essential for permanent wound closure, is the major problem. Recent advances in growth of cultured epidermal autograft (CEA) have allowed closure of full- and partial-thickness burns; in approximately 3 weeks, a 2 cm2 biopsy specimen will produce enough CEA to cover a pediatric patient. Since 1989, we have used this product on nine patients; the average age was 39, and the average TBSA burn was 70% (range, 44% to 93%). We report our approach to use of CEA in six of these patients, including topical applications of 1% silver sulfadiazine and excision of full- and deep partial-thickness wounds within 2 weeks of injury. Temporary closure was achieved with cadaver allograft. "Take" of the allograft forecasted take of CEA. The total operative time of CEA placement was decreased by a two-step technique that obviates repeating debridement: the technique consists of debriding and grafting with allograft, then removing it at the time of CEA placement. CEA take is best on early granulation tissue or freshly excised wounds. Early excision of burn eschar, temporary wound closure with cadaveric allograft and Biobrane (Winthrop Pharmaceuticals, Wound Care Div., Fountain Valley, Calif.), and permanent closure with CEA may improve survival rates among patients with massive burn wounds. CEA is a tremendous asset to the management of massive burn injuries.     

Octylcyanoacrylate for the Treatment of Partial-thickness Burns in Swine: A Randomized, Controlled Experiment

OBJECTIVE: To compare re-epithelialization rates of superficial partial-thickness burns treated with octylcyanoacrylate (OCA), silver sulfadiazine (SSD), and dry gauze (controls) in swine. METHODS: This was a prospective, longitudinal, blinded, controlled, experimental trial using anesthetized swine. Sixty-three standardized burns were created by applying an aluminum bar preheated to 80 degrees C for 20 seconds to the flanks of four young pigs. Three equal sets of 21 burns were randomly treated with OCA spray, SSD, or dry gauze (controls). Full-thickness biopsies were taken after 30 minutes and at seven and 14 days for blinded histopathologic evaluation by two dermatopathologists using hematoxylin and eosin staining. The percent of wound re-epithelialization was measured at days 7 and 14, calculated by dividing the length of the regenerated epidermis by the measured width of the biopsy. Analysis of variance (ANOVA) and repeated-measures ANOVA controlling for the individual pig were used for comparisons among groups. This study had 80% power to demonstrate a large between-group difference in percent re-epithelization (alpha = 0.05). RESULTS: There were 63 burns and 126 biopsies. Ten biopsies were excluded for technical reasons. At seven days, there was a significant between-group difference in percent re-epithelialization. Percent re-epithelialization was greatest in the OCA group (65.0%), followed by the SSD group (37.6%), and lowest in the control group (8.8%). At 14 days, all wounds demonstrated near complete re-epithelialization and there was no significant difference in the percent of re-epithelialization among the groups. There was only one wound infection in the OCA group. CONCLUSIONS: Under these study conditions, treatment of partial-thickness burns with OCA spray resulted in a higher percent of re-epithelialization at seven but not 14 days when compared with both SSD and control, with no significant increase in infection rates. Future studies should evaluate the use of OCA for the treatment of burns in humans.     

防疤烧伤膏对烫伤创面的促愈合效应(英文)

目的在观察防疤烧伤膏疗效基础上,进一步研究该药对烫伤创面的促愈合作用,并探讨其可能机制。方法4只小型猪背部各制备9个面积为2.54cm2的深II度烫伤创面,并将创面随机分为3组(每组12个创面),即防疤烧伤膏治疗组,凡士林治疗组,空白对照组。以创面面积、创面组织增殖细胞核抗原(PCNA)检测及组织学检查评价各级治疗效果。结果伤后11d防疤烧伤膏治疗组创面面积缩小为(0.10±0.03)cm2,明显小于凡士林组犤(0.81±0.54)cm2t=-3.22,P<0.05犦和空白对照组犤(0.70±0.21)cm2,t=-6.93,P<0.05犦;PCNA检测显示伤后7,11d各组创面组织均为强阳性表达;组织学检查表明伤后7d防疤烧伤膏治疗组的创面纤维组织生长多于凡士林组和空白组,伤后11d防疤烧伤膏治疗组创面已基本愈合,而凡士林组和空白对照组仍残留部分创面。结论防疤烧伤膏促进烫伤创面愈合的作用表现为溶解创面痂皮,促进纤维组织和表皮生长。