不同敷料对局部小面积烧伤创面的护理效果

The Nursing Effect of Different Dressings on Local Small Area Burn Wound

摘要: 目的：比较不同敷料对局部小面积烧伤创面的治疗效果。方法：按照纳入标准收集2017年12月~2020年1月期间在我院治疗的100例烧伤病人分为5组每组20例，采用传统磺胺嘧啶银纱布、银离子泡沫敷料、银离子海藻酸钙敷料、锌离子海藻酸钙敷料以及海藻酸钙敷料这五种不同的敷料对创面进行护理治疗，过程中观察记录创面愈合情况、创面感染情况、创缘炎症反应以及换药疼痛程度等与护理效果相关的各项指标，多重比较分析不同敷料各项指标的组间差异。结果：使用传统磺胺嘧啶银纱布和泡沫敷料的患者伤口愈合时间比三种海藻酸钙敷料长(P < 0.05)；换药次数最多的是传统磺胺嘧啶银纱布组，其次是三种海藻酸钙敷料组，银离子泡沫敷料组的换药次数最少，这三组之间有显著的组间差异(P < 0.05)；另外，这五种不同的敷料均未发生创面感染，并且只有传统磺胺嘧啶银纱布组发生了显著高于其他组的创缘炎症反应(P < 0.05)；在换药疼痛程度的评价方面，其他四组的疼痛程度均小于传统磺胺嘧啶银纱布组(P < 0.05)。结论：泡沫敷料和海藻酸钙敷料均可替代传统的磺胺嘧啶银纱布敷料，海藻酸钙敷料能加速伤口愈合，而泡沫敷料由于换药次数少可以减少护理人力成本，另外，在一定条件下抗菌药物的使用可能是非必须的，因此可综合考虑具体情况使用不同功效不同材质的敷料。

Abstract: Objective: To compare the therapeutic effect of different dressings on local small area burn wound. Methods: 100 cases of burn patients in our hospital from December 2017 to January 2020 were collected in accordance with the inclusion criteria. They were divided into 5 groups, 20 cases in each group. The traditional silver sulfadiazine (SSD), silver-containing foam dressing, silver-containing calcium alginate, zinc-containing calcium alginate and calcium alginate dressings of five different dressings on wound care and treatment, observe and record all indexes related to nursing effect, such as wound healing, wound infection, wound edge inflammation and dressing change pain, and the differences of various indexes of different dressings between groups were analyzed by multiple comparisons. Results: Patients using traditional SSD and foam dressings had longer wound healing times than those using three calcium alginate dressings (P < 0.05). The traditional SSD group had the most dressing changes, followed by the three calcium alginate dressing groups, and the silver-containing foam dressing group had the least dressing changes, indicating a significant difference between the three groups (P < 0.05). In addition, none of the five different dressings had wound infection, and only the traditional SSD group had significantly higher marginal inflammatory response than the other groups (P < 0.05). In the evaluation of the pain degree of dressing change, the pain degree of the other four groups was lower than that of the traditional SSD group (P < 0.05). Conclusion: Foam dressings and calcium alginate dressings can replace traditional SSD dressings, calcium alginate dressings can accelerate wound healing, and foam dressing due to low replacement frequency can reduce the nursing manpower cost; in addition, under certain conditions, the use of antimicrobial agents may be unnecessary. Therefore, dressings of different efficacy and different materials can be used comprehensively considering the specific situation.