摘要
目的探讨软聚硅酮银离子泡沫敷料在烧伤患者头部供皮区创面处理中的临床效果。方法回顾性分析2020年1月至2023年1月联勤保障部队第九四○医院收治的烧伤患者临床资料, 患者术中取头部刃厚皮片修复深度烧伤创面, 头部供皮区创面覆盖软聚硅酮银离子泡沫敷料(A组)或凡士林油纱(B组)。比较2组间以下5个指标的差异:(1)术后创面愈合时间;(2)初次换药疼痛评分, 采用数字评定量表(NRS)评估, 0分为无痛, 1~3分为轻度疼痛, 4~6分为中度疼痛, 7~10分为重度疼痛;(3)创面换药次数;(4)二次创伤评分, 总分1~3分, 评分越高创伤越严重;(5)创面甲级愈合比例(甲级愈合例数/各组总例数×100%)。根据数据类型组间比较采用t检验、Wilcoxon秩和检验或卡方检验, P<0.05为差异有统计学意义。结果共纳入60例患者, A、B组各30例。A组男18例, 女12例;年龄(29.4±16.6)岁;烧伤面积为(21.43±5.66)%总体表面积(TBSA), 头部取皮面积为(1.80±0.61)% TBSA;B组男20例, 女10例;年龄(30.2±16.2)岁;烧伤面积为(21.37±5.67)%TBSA, 头部取皮面积为(1.78±0.63)% TBSA。2组患者性别、年龄、烧伤面积、头部取皮面积比较, 差异均无统计学意义(P均>0.05)。A组头部供皮区创面愈合时间短于B组[(5.97±0.41) d vs. (6.93±0.58) d, t=-7.40, P<0.001];A组初次换药疼痛NRS评分低于B组[3.0(2.0, 4.0)分vs. 5.5(4.0, 6.0)分, Z=-4.82, P<0.001];A组创面换药次数低于B组[2(2, 2)次vs. 4(3, 5)次, Z=-6.64, P<0.001];A组二次创伤评分低于B组[1(1, 1)分vs. 3(3, 3)分, Z= -7.08,P<0.001];A组创面甲级愈合比例为96.7%(29/30), B组为90.0%(27/30), 两者比较差异无统计学意义(χ^(2)=0.27, P=0.605)。结论应用软聚硅酮银离子泡沫敷料覆盖烧伤患者头部供皮区创面, 疗效明显优于凡士林油纱, 能缩短创面愈合时间, 减少换药次数, 减轻疼痛, 减少二次创伤发生, 提高患者舒适度。
Objective Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023.Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds,with the denuded scalp area covered by either silicone silver ion foam dressing(Group A)or petrolatum gauze(Group B).Comparison of the following 5 parameters between the two groups:(1)Postoperative wound healing time.(2)Initial dressing change pain score was assessed using the numeric rating scale(NRS).0 points indicated no pain,1-3 points indicated mild pain,4-6 points indicated moderate pain,and 7-10 points indicated severe pain.(3)Number of dressing changes.(4)Secondary trauma score,with a total score ranging from 1 to 3,where a higher score indicates more severe trauma.(5)Proportion of wounds healed to grade A(number of grade A healed cases/total number of cases in each group×100%).Depending on the data type,between-group comparisons were performed using t-test,Wilcoxon rank-sum test,or chi-square test.P<0.05 was considered a statistically significant difference.Results A total of 60 patients,with 30 in each Group A and Group B,were included in the study.Group A was comprised of 18 males and 12 females,with an average age of(29.4±16.6)years.The burn area was(21.43±5.66)%of the total body surface area(TBSA),and the area of skin taken from the scalp was(1.80±0.61)%of TBSA.Group B was comprised of 20 males and 10 females,with an average age of(30.2±16.2)years.The burn area was(21.37±5.67)%of TBSA,and the area of skin taken from the scalp was(1.78±0.63)%of TBSA.No statistically significant differences were observed in gender distribution,age,burn area,and scalp area between the two groups(P>0.05).The wound healing time in the denuded scalp area was shorter in Group A than in Group B[(5.97
作者
王鹏
徐承新
孙晓晨
魏霞
宋玫
Wang Peng;Xu Chengxin;Sun Xiaochen;Wei Xia;Song Mei(Burn and Plastic Surgery Center,the 940th Hospital of Joint Logistics Support Force of PLA,Lanzhou 730000,China;Department of Burns and Cutaneous Surgery,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,China)
出处
《中华整形外科杂志》
CSCD
北大核心
2024年第1期76-81,共6页
Chinese Journal of Plastic Surgery
关键词
头皮
供区
创面
泡沫敷料
烧伤
凡士林油纱
Scalp
Donor site
Wound
Foam dressing
Burns
Petrolatum gauze
