联合应用藻酸盐和聚亚安酯敷料促进中厚皮供区创面愈合的临床观察  

Combination of alginate and polyurethane dressings promotes wound healing at split-thickness skin graft donor sites: a clinical observation

作　　者：杜川[1] 邓凡[1] 周维忠[1] 戴霞[2] 

机构地区：[1]贵州省兴义市人民医院烧伤整形外科,562400 [2]第三军医大学附属西南医院整形美容科,400038

出　　处：《中华损伤与修复杂志（电子版）》2011年第5期47-49,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨联合应用藻酸盐和自粘型聚亚安酯敷料于中厚皮片供皮区,加速创面愈合的方法。方法烧伤后瘢痕整形中厚皮取皮术后,实验组19例以藻酸盐和自粘型聚亚安酯敷料顺序联合应用覆盖供皮区创面,对照组17例以传统的凡士林纱布加棉垫绷带加压包扎供皮区创面,受术者于术后第1天、第2天及第10天揭除敷料时就供皮区疼痛程度按疼痛视觉模拟评分,并对敷料对术后活动的影响、术后10d揭除敷料难易程度进行评价,记录两组供皮区创面愈合的时间。结果术后第1天、第2天及术后第10天揭除敷料时,实验组受术者的疼痛视觉模拟评分低于对照组,实验组中36.8%受术者术后活动不受限,高于对照组(P<0.05);术后10d,实验组揭除敷料更为容易,且实验组供皮区愈合时间平均为9.8d,短于对照组(P<0.01)。结论藻酸盐敷料和聚亚安酯敷料联合应用于中厚皮片供皮区,具有降低术后疼痛,减轻术后活动不便,操作方便,缩短供皮区愈合时间的优点,值得临床推广应用。Objective To improve the dressing method for split-thickness skin graft donor sites, promote donor site healing, and mitigate scarring. Methods Following harvest of split-thickness skin grafts, the wound was immediately covered with alginate dressing and then self-adhesive polyurethane dressing in the experimental group, and was covered with Vaseline gauze and cotton pads and then compressed with bandage in the control group. On days 1, 2 and 10 after surgery, the pain level was scored upon removal of the dressing using the visual analog scale for pain. In addition, the effect of dressings on postoperative movements was assessed. The difficulty in removing the dressings on day 10 after surgery was also assessed, and the time to wound healing was recorded. Results On days 1, 2 and 10 after surgery, the pain scores were significantly lower in the experimental group than the control group （P0.05）. In the experimental group, 36.8% of the patients’ movements were not affected by the dressings. In contrast, all patients’ movements were affected by the dressings. The rate of no or mild difficulty in removing dressing on day 10 after surgery was significantly higher in the experimental group than the control group （P0.05）. The time to wound healing was significantly shorter in the experimental group than the control group （P 0.01）. Conclusions The combined application of alginate dressing and polyurethane dressing to split-thickness skin graft donor sites mitigated postoperative pain and movement limitations, facilitated manipulation and shortened the time to wound healing. Hence, this method can be used widely.

关 键 词：藻酸盐 聚亚安酯 敷料 创伤和损伤 

分 类 号：R644[医药卫生—外科学]