吸水性聚氨酯泡沫敷料促进皮肤移植供皮区愈合的疗效观察

Clinical evaluation of polyurethane foam dressing on wound healing of skin graft donor site

目的评价一种吸水性聚氨酯泡沫敷料促进皮肤移植(植皮术)供皮区愈合的效果。方法选取120例接受植皮术的烧伤患者作为研究对象,患者随机分为Medifoam组(刃厚皮供皮区和中厚皮供皮区创面各30例)和油纱组(刃厚皮供皮区和中厚皮供皮区创面各30例)。Medifoam组供皮区创面直接以吸水性聚氨酯泡沫敷料(Medifoam敷料)贴敷,油纱组供皮区创面则采用凡士林油纱外敷。观察各组供皮区创面的愈合时间、疼痛程度、感染情况和愈合效果,直至创面完全干燥且上皮化。结果Medifoam组与油纱组创面感染发生率比较差异无统计学意义(P>0.05)。与油纱组比较,Medifoam组供皮区创面的愈合时间提前(P<0.01),换药疼痛轻微(P<0.01),创面愈合后无明显色素沉着和瘢痕形成。结论以吸水性聚氨酯泡沫敷料贴敷植皮术供皮区创面,能够明显减轻供皮区创面疼痛,创面上皮化快且愈合质量高。

Objective To investigate the clinical effect of a polyurethane foam dressing on the wound healing of skin graft donor site. Methods A total of 120 hospitalised burn patients with skin graft surgery were randomly divided into Medifoam group （n = 60） and gauze group （n = 60）. Skin graft donor sites in Medifoam group were treated with a polyurethane foam dressing, while those in gauze group were treated with vaseline gauze. The wound healing time of donor sites, degree of pain, infections and cosmetic outcomes of two groups were compared and statistically analyzed. Results There was no significant difference in the infection rate of would between two groups （ P 〉 0.05）. Compared with gauze group, the time of wound healing of donor sites was significantly shorter （P 〈 0.01）, the degree of pain was significantly alleviated （P 〈 0.01）, and the pigmentation and scar forming were less obvious in Medifoam group. Conclusion Polyurethane foam dressing has the advantage of relieving pain, accelerating wound healing and reducing pigmentation and scar forming in application in skin graft donor site.