软聚硅酮敷料联合藻酸钙敷料用于烧伤后皮肤移植供皮区的疗效观察

目的 观察软聚硅酮敷料联合藻酸钙敷料应用于烧伤后皮肤移植供皮区的疗效.方法 将80例烧伤患者随机分为试验组(n=39)和对照组(n=41).试验组供皮区内层覆盖藻酸钙敷料(德湿康敷料),外层覆盖软聚硅酮敷料(美皮康);对照组供皮区内层覆盖洗必泰油纱,外层覆盖多层无菌纱布.评价两组患者供皮区的创面愈合、疼痛改善及瘢痕形成情况.结果 术后第7、10、12天试验组创面愈合率[(51.31±7.09)％、(78.77±8.80)％、(96.44±3.24)％]均高于对照组[(45.85±5.54)]％、(73.63±7.73)％、(93.12±4.08)％],差异有统计学意义(P＜0.01).试验组创面愈合时间短于对照组[(10.95±1.41)d vs (11.93±1.44)d,P＜0.01].术后第1、3、7、10天试验组视觉模拟评分(VAS)为5.36±1.21、4.29±1.25、4.00±0.46、1.00±0.45,均低于对照组(7.34±1.34、5.89±1.39、4.50±0.74、1.35±0.52),差异有统计学意义(P＜0.01).创面愈合后第1、3、6、12个月试验组温哥华瘢痕评价(VSS)评分(3.82±1.47、6.00±1.61、3.77±2.28、2.59±1.39)均低于对照组(5.80±1.68、7.80±1.65、5.24±1.67、4.05±1.41),差异有统计学意义(P＜0.01).结论 软聚硅酮敷料与藻酸钙敷料联合应用可以显著提高供皮区创面愈合率、缩短创面愈合时间、缓解换药疼痛、改善愈合质量,有望成为有效的保护供皮区的临床治疗手段之一.

Curative effect of soft silicone dressing combined with calcium alginate dressing in treating skin graft donor sites of burned patients

Objective To observe the curative effect of soft silicone dressing combined with calcium alginate dressing for treatment of skin graft donor sites of burned patients. Methods A total of 80 burned patients were randomly divided into treatment group (n=39) and control group (n=41). In the treatment group the donor sites were covered with calcium alginate dressing (Sorbalgon) inside and soft silicone dressing (Mepilex) outside, and the donor sites in the control group were covered with chlorhexidine gauze inside and multilayer sterile gauze outside. The wound healing, pain improvement and scar formation were evaluated in the two groups. Results The wound healing rates at post-operative 7, 10 and 12 d in the treatment group were significantly higher than those in the control group (treatment group:[51.31±7.09]%,[78.77±8.80]% and[96.44±3.24]%; control group:[45.85±5.54]%,[73.63±7.73]% and[93.12±4.08]%; P<0.01). The wound healing time of the treatment group was significantly shorter than that of the control group ([10.95±1.41] d vs[11.93±1.44] d, P<0.01). Visual analogue scale (VAS) scores at post-operative 1, 3, 7 and 10 d in the treatment group were significantly lower than those in the control group (treatment group:5.36±1.21, 4.29±1.25, 4.00±0.46 and 1.00±0.45; control group:7.34±1.34, 5.89±1.39, 4.50±0.74 and 1.35±0.52; P<0.01). The Vancouver scar scale (VSS) scores at post-operative 1, 3, 6 and 12 month in the treatment group were also significantly lower than those in the control group (treatment group:3.82±1.47, 6.00±1.61, 3.77±2.28 and 2.59±1.39; control group:5.80±1.68, 7.80±1.65, 5.24±1.67 and 4.05±1.41; P<0.01). Conclusion Soft silicone dressing combined with calcium alginate dressing in treatment of the skin graft donor sites can greatly improve the wound healing rate, shorten the wound healing time, relieve pain in dressing change and improve the wound healing quality, and it may serve as an effective method for protecting the donor sites.