两种功能性敷料联合优力抒弹力绷带用于皮片移植术供皮区创面的疗效研究  

Effect of silver sulfadiazine cream and calcium alginate combined with elastic bandage for dressing donor skin graft wound

作　　者：董敏 黄素群[1,3] 殷学利 郑敏[3] 毕科[3] 罗成琴 DONG Min;HUANG Suqun;YIN Xueli;ZHENG Min;BI Ke;LUO Chengqin(Wound Center, Second Hospital Affiliated to Chongqing Medical University, Chongqing, 400010;Department of Nursing, Sichuan College of Traditional Chinese Medicine, Mianyang, Sichuan Province, 621000, China;Department of Emergency Medicine, Second Hospital Affiliated to Chongqing Medical University, Chongqing, 400010)

机构地区：[1]重庆医科大学附属第二医院伤口中心,重庆400010 [2]四川中医药高等专科学校护理学院,绵阳621000 [3]重庆医科大学附属第二医院急诊外科,重庆400010

出　　处：《第三军医大学学报》2019年第20期2000-2005,共6页Journal of Third Military Medical University

基　　金：重庆市科学技术委员会技术创新与应用示范项目(CSTC2018jscx-msybX0025)~~

摘　　要：目的观察两种功能性敷料联合优力抒弹力绷带应用于自体皮片移植术供皮区创面的疗效。方法采用动态随机法将我科2018年1-12月收治的96例自体皮片移植术患者分为实验组和对照组,各48例。实验组采用两种功能性敷料联合优力抒的"三明治"包扎法,即创面内层放置磺胺嘧啶银脂质水胶敷料(优拓SSD),中层放置藻酸盐敷料,外层覆盖无菌棉垫后用优力抒弹力绷带加压固定。对照组采用传统包扎法,即创面放置凡士林纱布后覆盖无菌棉垫,然后纱布绷带加压包扎。对比两组患者创面局部情况(包括敷料移位情况、渗血渗液量)、创面愈合情况(包括术后7、10、12 d创面愈合率和愈合时间)、患者主观舒适度及瘢痕形成情况。结果①创面局部情况:实验组敷料移位情况、渗血渗液量明显少于对照组(P<0.05)。②创面愈合情况:实验组术后7、10、12d创面愈合率均高于对照组(P<0.05);与对照组相比,实验组创面愈合时间明显缩短(P<0.05)。③实验组患者主观舒适度较对照组更高(P<0.05)。④实验组创面愈合后第3、6个月VSS评分均低于对照组(P<0.05)。结论将优拓SSD、藻酸盐两种功能性敷料联合优力抒弹力绷带采用"三明治"包扎法应用于皮片移植术供皮区创面的处理,可有效防止敷料移位,减少渗血渗液量,缩短创面愈合时间,改善主观舒适度,减少瘢痕形成,值得临床进一步推广运用。Objective To assess the effect of silver sulfadiazine cream and calcium alginate combined with elastic bandage dressing on the healing of autologous donor skin graft wounds. Methods Between January and December, 2018, 96 patients were admitted in our department for autologous skin graft wound management. The patients were randomized equally into experimental group and control group, and in the former group, the wounds in the donor area were dressed with a "sandwich" dressing method using silver sulfadiazine cream and calcium alginate, which were covered with sterile cotton pads and strapped with elastic bandage. In the control group, the wounds were managed with conventional compression dressing using vaseline gauze, sterile cotton pads, and gauze bandage. The displacement of dressings, bleeding and exudation of the wounds, wound healing time, subjective comfort level of the patients, and scar formation were compared between the two groups. Results The rate of displacement of dressings and the volume of wound bleeding and exudation were significantly lower in the experimental group than in the control group(P<0.05). Compared with the control group, the experimental group showed significantly higher wound healing rates at 7, 10 and 12 days after the surgery(P<0.05) with a shortened wound healing time(P<0.05), a higher subjective comfort level(P<0.05), and significantly lower VSS scores at 3 and 6 months after wound healing(P<0.05). Conclusion Dressing donor skin graft wounds with the "sandwich" bandaging using silver sulfadiazine cream and calcium alginate combined with elastic bandage can effectively prevent the displacement of the dressing, reduce wound bleeding, shorten the wound healing time, improve the subjective comfort, and reduce scar formation.

关 键 词：皮片移植术 供皮区 中厚皮 功能性敷料 

分 类 号：R473.6[医药卫生—护理学] R618[医药卫生—临床医学]