软聚硅酮银离子敷料应用于烧伤创面的效果评价

Effect of soft silicone silver ion dressing applied in burn wounds

背景:软聚硅酮银离子敷料是一种运用Safetac技术制成的高分子有机化合物,具有抗感染、吸渗性好、透气性好等特性,能为创面愈合提供良好的湿润环境。目的:评价软聚硅酮银离子敷料修复深Ⅱ度及以下程度烧伤创面的有效性。方法:应用计算机全面检索知网、维普、万方、中国生物医学文献数据库和Pub Med、Embase、Web of Science数据库,选择软聚硅酮银离子敷料修复深Ⅱ度及以下程度烧伤创面的随机对照试验,治疗组为单独软聚硅酮银离子敷料治疗,或软聚硅酮银离子敷料联合常规治疗,或联合其他治疗;对照组为常规治疗,或其他治疗,或安慰剂治疗。对文献进行筛选、信息提取和质量评价后,利用Review Manager 5.3软件进行Meta分析。结果与结论:(1)共纳入11篇文献,784例患者,治疗组381例,对照组403例;(2)Meta分析结果显示:治疗组在第7,14,21天及最后一次测量的烧伤创面愈合率均高于对照组[OR=11.56,95%CI(9.60,13.53),P<0.00001;OR=13.29,95%CI(7.54,19.04),P<0.00001;OR=4.10,95%CI(2.28,5.93),P<0.0001;OR=1.17,95%CI(0.42,1.93),P=0.002],烧伤创面愈合时间短于对照组[OR=-2.81,95%CI(-3.49,-2.12),P<0.00001],烧伤创面疼痛程度低于对照组[OR=-0.38,95%CI(-0.53,-0.24),P<0.00001];两组烧伤创面细菌培养阳性率、伤口感染、换药次数、创面治疗费用、不良反应等比较差异均无显著性意义[OR=1.16,95%CI(0.47,2.85),P=0.74;OR=1.44,95%CI(0.47,4.41),P=0.52;OR=-8.04,95%CI(-18.82,2.74),P=0.14;OR=-98.26,95%CI(-272.91,76.40),P=0.27;OR=0.61,95%CI(0.31,1.20),P=0.15];(3)结果表明,软聚硅酮银离子敷料应用于深Ⅱ度及以下程度的烧伤创面能提高创面愈合率,缩短创面愈合时间,减轻疼痛。

BACKGROUND:Soft silicone silver ion dressing,a kind of high molecular weight organic compound prepared with Safetac technology,has the characteristics of anti-infection,good permeability and good air permeability.It can provide a good moist environment for wound healing.OBJECTIVE:To evaluate the effectiveness of soft silicone silver ion dressings in repairing deepⅡdegree and milder burn wounds.METHODS:A computer-based retrieval of CNKI,VIP,WanFang,CBM,PubMed,Embase and Web of Science databases was performed.The randomized controlled trials concerning soft silicone silver ion dressing for repairing deepⅡdegree and milder burn wounds were selected.The treatment group was treated with a single soft silicone silver ion dressing,or a soft silicone silver ion dressing combined with conventional treatment,or combined with other treatments.The control group was treated with conventional treatment,or other treatments,or placebo.After screening,data extraction and quality evaluation,meta-analysis was performed using Review Manager 5.3 software.RESULTS AND CONCLUSION:(1)Eleven articles were included,involving 784 patients,381 patients in the treatment group and 403 patients in the control group.(2)The results of meta-analysis showed that the burn wound healing rate in the treatment group was higher than that in the control group[OR=11.56,95%CI(9.60,13.53),P<0.00001;OR=13.29,95%CI(7.54,19.04),P<0.00001;OR=4.10,95%CI(2.28,5.93),P<0.0001;OR=1.17,95%CI(0.42,1.93),P=0.002]at 7,14 and 21 days,and the last measurement.The healing time of burn wounds in the treatment group was shorter than that in the control group[OR=-2.81,95%CI(-3.49,-2.12),P<0.00001].The degree of pain in burn wounds in the treatment group was lower than that in the control group[OR=-0.38,95%CI(-0.53,-0.24),P<0.00001].There was no significant difference in the positive rate of bacterial culture on wound surface[OR=1.16,95%CI(0.47,2.85),P=0.74],burn wound infection[OR=1.44,95%CI(0.47,4.41),P=0.52],dressing frequency[OR=-8.04,95%CI(-18.82,2.74),P=0.14],wound treatment cost[OR=-98.26,95%CI(-272.91,76.40),P=0.27]and adverse reaction[OR=0.61,95%CI(0.31,1.20),P=0.15]between treatment and control groups.(3)These results show that the application of soft silicone silver ion dressing on deepⅡdegree and milder burn wounds can improve wound healing rate,shorten wound healing time and alleviate pain.