A Study on Post-burn Healing: Optimising Scar Outcome Through the Use of a Silicone-based Film-forming Wound Dressing
Notice bibliographique
Résumé
Introduction The development of scarring is a normal physiological response during burn wound healing for any except the most trivial of injuries. Burn scarring can cause considerable functional and psychological anguish in burn survivors. Prolonged wound healing has been shown to affect scarring outcomes. Superficial cutaneous wound injuries carry a risk of scarring and altered pigmentation after the wound has healed. The primary aim of this study was to explore the effects of topical silicone on the rate of wound healing in superficial wounds. Secondary aims included investigation of scar and pain outcomes. Methods This thesis presents two studies which explored the efficacy of topical silicone film-forming dressings (StrataXRT and Stratamed) in comparison to standard care. Two independent double-blinded, single-centre, randomised controlled studies were conducted, one focussed on donor sites of split thickness skin grafts (STSG) using StrataXRT, and the other, superficial partial thickness (SPT) face and neck burns using Stratamed. For both studies, time to healing (TTH) was the primary outcome of interest. Secondary outcomes included 1) scar assessments (modified Vancouver Scar Scale; Dermalab Combo and Patient and Observer Scar Assessment Scale) at six weeks and three months, and 2) pain intensity scale during dressing changes. In the donor site study, 30 eligible burn patients requiring surgery aged between 18 and 80 years with a donor site wound ≤ 3% total burn surface area (TBSA) were enrolled. The intervention, StrataXRT, was randomly assigned to one half of the donor site or a single donor site where multiple donor passes were required, within the same patient and applied underneath standard care calcium alginate dressings. In the facial burn patient study, 55 patients aged between 18 and 80 years with a non-epithelialised superficial partial thickness face or neck burns were randomised to receive Stratamed or standard care emollient for the topical management of their wounds. Results Of the 30 participants enrolled in the donor study, 24 (80%) were male. Median age was 39 years with a range from 20 years to 76 years. Donor site size ranged from 0.1% to 3% TBSA. The median TTH for the intervention group was 10 days (CI 8 - 12) and the control group was 9 days (CI 8 - 10) There was no evidence of a statistical difference observed in time to healing, pain and scar outcomes. Of the 55 participants in the face/neck study, 34 (62%) were male. Median age was 36 years with a range from 25 to 47 years. The median TTH for the intervention group was 9 days (CI 7.6 -10.4) and the control group was 7 days (CI 5.3- 8.7), this result was not significant, p = 0.056. The silicone intervention group exhibited significantly reduced scar pigmentation at six weeks in mVSS scores for the intervention group (Md = 0, IQR = 0) compared to the control group (Md = 0, IQR = 0 - 3), p = 0.043. There was no significant difference in pain between the intervention group (Md = 1.15, IQR 0.3 – 4.5) and the control group (Md = 1.5, IQR 0.6 – 3.8), z = -0.63, p = 0.53. No, adverse events were associated with the topical silicone in either study. Conclusion These studies were unable to show any clinically applicable advantage over standard care through the use of topical silicone dressings on donor site wounds and SPT burn wounds of the face and neck. The observation that silicone film-forming dressing systems were associated with a reduction in scar pigmentation and no observed adverse events warrants further studies.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».