硅酮敷料结合压力疗法抑制术后瘢痕的应用效果

Efficacy of Silicone Dressing Combined with Pressure Therapy for Controlling Postoperative Scars

目的比较自粘性硅酮敷料结合压力疗法及单纯压力疗法对抑制手术后切口疤痕增生的效果。方法采用随机对照试验，选取2010年3月-2012年12月在湖南省肿瘤医院造口伤口中心就诊的手术后切口疤痕增生时间小于2年的患者148例，观察组78例用自粘性硅酮敷料结合压力疗法，对照组70例单纯采用压力疗法。参照温哥华瘢痕判定标准对两个组治疗前后的瘢痕色泽、血管分布、柔软度、厚度进行评分，结果采用尼莫地平计算法。结果①3个月时复查情况：观察组78处瘢痕，10处痊愈（12．8％），18处显效（23．1％），28处有效（35．9％），22处无效（28．2％）；对照组70处瘢痕，2处显效（2．9％），22处有效（31．4％），46处无效（65．7％）。②6个月时复查情况：观察组78处瘢痕，22处痊愈（28．2％），30处显效（38．5％），18处有效（23．1％），8处无效（10．3％）；对照组70处瘢痕，6处痊愈（8．8％），16处显效（23．5％），20处有效（29．4％），28处无效（40．0％）。结论自粘性硅酮敷料结合压力疗法治疗手术后切口疤痕增生效果优于单纯压力疗法。

Objective To compare the efficacy of controlling postoperative scars between self - adhesive silicone dressing combined with pressure therapy and simple pressure therapy. Methods 148 patients with postoperative scars less than 2 years from Mar. 2010 to Dec. 2012 were randomly assigned to experimental group（78 patients） and control group（70 patients）. Self- adhesive silicone dressing combined with pressure therapy was performed in experimental group with simple pressure therapy in the control group. Color, vascularity, flexibility and thickness of scar were graded according to Vancouver Scar Judging Standard in both groups before and after treatment,with nimodipine calculation in the results. Results ①78 scars were in the experimental group, including 10 recovery （ 12.8% ） ,9 markedly effective（23.1% ） ,28 effective（35.9% ） and 22 invalid（28.2% ） 3 months after. 70 scars were in the control group,including 2 markedly effective （2.9 % ） ,22 effective （31.4% ） and 46 invalid （65.7 % ）. ②78 scars were in the experimental group,including 22 recovery（28.3% ） ,30 markedly effective（38.5% ） ,18 effective（23.1% ） and 8 invalid （10.3 % ） 6 months after. 70 scars were in the control group, including 16 markedly effective （23.5 % ） , 20 effective （ 29.4% ） and 28 invalid（40.0% ）. Conclusion Self - adhesive silicone dressing combined with pressure therapy is superior to simple pressure therapy in controlling postoperative scars.