比较3M透明敷贴与凡士林纱布治疗指端缺损的临床疗效

Comparison of effects of 3M tegaderm films and petrolatum gauzes on the treatment of fingertip defects

目的比较3M透明敷贴与凡士林纱布包扎治疗AllenⅠ型指端缺损的临床疗效。方法前瞻性对照研究2016年1月-2017年6月AllenⅠ型指端缺损60例。按治疗方式分为透明敷贴组和凡士林纱布组。比较两组首次换药时疼痛程度、初步愈合时间及感染率,术后1年随访指端两点辨别觉、瘢痕程度、指纹恢复情况、患者满意度以及恢复工作时间。结果两组均获得12~24个月(平均18个月)随访。两组均未发生感染,恢复工作时间两组无明显差异。透明敷贴组满意率100%,凡士林纱布组有2例因瘢痕明显而不满意,满意率93.3%。透明敷贴组创面初步愈合时间、首次换药VAS疼痛评分明显低于凡士林纱布组。术后12个月透明敷贴组再生皮肤两点辨别觉明显优于凡士林纱布组。透明敷贴组创面愈后无明显瘢痕,指纹恢复明显;凡士林纱布组部分可见明显瘢痕,指纹恢复不明显。结论3M透明敷贴治疗AllenⅠ型指端组织缺损较传统凡士林纱布具有加速创面愈合、减轻换药时疼痛及术后瘢痕的优势,是一种较为理想的治疗方式。

Objective To compare the effects of 3M tegaderm films and petrolatum gauzes on the treatment of AllenⅠfingertip defects.Methods From January 2016 to June 2017,60 cases of AllenⅠfingertip defects were treated,30 were treated with 3M tegaderm films and 30 with petrolatum gauzes.Two groups were compared in VAS pain score,initial healing time,infection rate,two-point discrimination,scar,fingerprint,patient satisfaction,and the time of return to work.Results All cases were followed up for 12 to 24 months(averaged 18 months).All 60 cases healed without infections.There was no significant difference in the time of return to work between the two groups.The satisfaction of the 3M tegaderm film group was 100%,and the satisfaction rate of the petrolatum gauze group was 93.3%due to the obvious scar.The initial healing time and VAS pain score were significantly lower in 3M tegaderm film group than petrolatum gauze group.When followed up after 12 months,the two-point discrimination of the 3M tegaderm film group was significantly superior to the petrolatum gauze group.There was no obvious scar in the 3M tegaderm films group,and the fingerprint recovery was obvious.While part of petrolatum gauzes group showed obvious scar,and the recovery of fingerprint was not obvious.Conclusion In the treatment,occlusive dressings with 3M tegaderm films is an ideal method,with advantages of quick healing,less pain and less scar than petrolatum gauze dressings.