Management of Pediatric Skin-Graft Donor Sites: A Randomized Controlled Trial of Three Wound Care Products
Management of Pediatric Skin-Graft Donor Sites: A Randomized Controlled Trial of Three Wound Care Products
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DOI：
10.1097/bcr.0000000000000161
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发表时间：
2015-01-01
影响因子：
1.4
通讯作者：
O'Callaghan, Gill
中科院分区：
文献类型：
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作者：
Brenner, Maria;Hilliard, Carol;O'Callaghan, Gill
皮肤移植被用来治疗儿童多种类型的皮肤缺陷，包括烧伤、创伤性伤口和疤痕修复。这项前瞻性随机对照试验的目的是比较三种敷料类型对儿童供区的效果：泡沫敷料、纤维敷料和海藻酸钙敷料。2010年10月至2013年3月期间参加儿科烧伤与整形服务的儿童需要剥离皮肤移植，他们被招募到试验中。患者被随机分配到两个试验组，泡沫组或水纤维组，以及对照组，海藻酸钙。收集了渗出物的管理、疼痛评估、愈合时间和感染的数据。57名1至16岁(平均4.9岁)的儿童被招募到试验中。56名患者有可评估的数据，来自对照组的一名参与者失去了随访。大多数儿童因烧伤需要植皮(78%)。供区中位数为63.50 cm(2)(8~600 cm(2))。三种敷料组愈合时间差异有统计学意义(x(2)[2，n=56]=6.59，P=0.037)。海藻酸钙组愈合天数的中位数(中位数为7.5天)低于其他两组，中位数分别为8天(水纤维组)和9.5天(泡沫组)。无论敷料类型如何，渗出液的最大渗漏发生在植骨后第2天。在渗出物渗漏、疼痛评分或感染率方面，三组之间没有统计学上的显著差异。在这项试验中，藻酸钙是儿童供体部位愈合的最佳敷料。
Skin grafts are used to treat many types of skin defects in children, including burns, traumatic wounds, and revision of scars. The objective of this prospective randomized controlled trial was to compare the effectiveness of three dressing types for pediatric donor sites: foam, hydrofiber, and calcium alginate. Children attending a pediatric Burns & Plastics Service from October 2010 to March 2013, who required a split-skin graft, were recruited to the trial. Patients were randomly assigned to the two experimental groups, foam or hydrofiber, and to the control group, calcium alginate. Data were gathered on the management of exudate, assessment of pain, time to healing, and infection. Fifty-seven children aged 1 to 16 years (mean = 4.9 years) were recruited to the trial. Fifty-six patients had evaluable data and one participant from the control group was lost to follow-up. Most children required skin grafting for a burn injury (78%). The median size of the donor site was 63.50 cm(2) (8-600 cm(2)). There was a statistically significant difference in time to healing across the three dressing groups (x(2) [2, n = 56] = 6.59, P = .037). The calcium alginate group recorded a lower median value of days to healing (median = 7.5 days) compared to the other two groups, which recorded median values of 8 days (hydrofiber) and 9.5 days (foam). The greatest leakage of exudate, regardless of dressing type, occurred on day 2 after grafting. No statistically significant difference was found in leakage of exudate, pain scores, or infection rates across the three groups. Calcium alginate emerged as the optimum dressing for pediatric donor site healing in this trial.