新型功能敷料组合在皮肤移植供皮区的应用

Clinical evaluation of new functional dressing combination on skin graft donor site

目的:探讨新型功能敷料组合在供皮区的应用效果。方法:随机选取13例较小面积大腿供皮手术患者作为研究对象,大腿取皮后,将同"一刀"供皮区分为左右二个区域,随机纳入对照组(凡士林纱布组)和实验组(功能敷料组)进行自身对照。实验组分别使用藻酸盐(一级敷料)、泡沫敷料(二级敷料)、普通纱布(三级敷料)包扎供皮区,对照组使用凡士林纱布(一级敷料)、普通纱布(二级敷料)包扎供皮区。两组均7 d后开始换药,1次/3 d。观察创面愈合时间,采用视觉模拟评分法(VAS)比较第1次换药时疼痛度。术后随访6～12个月,使用温哥华量表观察瘢痕增生情况(VSS)。结果:所有纳入病例无1例发生感染、浸渍,愈合时间实验组(12. 10±2. 47) d,对照组(21. 50±4. 00) d;实验组VAS(2. 60±1. 77)分,对照组(6. 30±1. 26)分;实验组VSS (8. 08±1. 50)分,对照组(8. 08±1. 71)分。两组比较,实验组愈合时间提前,换药疼痛减轻(P <0. 01),而瘢痕增生情况,差异无统计学意义(P> 0. 05)。结论:新型敷料组合在供皮区的应用,可减少创面愈合时间,减轻患者在换药中的疼痛,渗液管理良好,值得临床应用。

Objective:To explore the application effect of new functional dressing combination on skin graft donor site.Methods:13 patients with small area of thigh were randomly selected as the subjects of study.After the skin was removed,the same donor site was divided into two regions,which were randomly included in the control group(vaseline gauze group)and experimental group(functional dressing group).The experimental group used alginate(primary dressing),foam dressing(secondary dressing),ordinary gauze(thirdary dressing),and the control group used vaseline gauze group(primary dressing),ordinary gauze(secondary dressing).Both groups began to change dressings after 7 days,and once every three days,the wound healing time was observed,and the pain degree at the first dressing change was compared by visual analogue scale(VAS).Postoperative follow-up of 6~12 months,using the vancouver scale to observe scar hyperplasia.Results:None of the cases were infected and infected,and the healing time was 12.10±2.47 days in the experimental group,and the control group was 21.50±4.00 days.The pain score was 2.60±1.77 in the experimental group,,the control group was 6.30±1.26,and the hyperplasia(VSS)test group was 8.08±1.50 in the experimental group,and the control group was 8.08±1.71.Compared with the two groups,the healing time of the experimental group was advanced,and the pain relief was reduced(P<0.01),while there was no significant difference in scar hyperplasia(P>0.05).Conclusion:The application of new dressings in the donor site can reduce the time of wound healing,relieve the pain of patients in the change of medicine,and the seepage management is good,which is worthy of clinical application.