The effect of hyperbaric oxygen therapy on split-thickness skin graft uptake in posttraumatic wounds and donor site healing: a randomized controlled trial.

IF 1.4 4区 医学 Q3 DERMATOLOGY
Madhur Uniyal, Irshad Ahmad, Ajay Kumar Dhiman, Ajay Kumar, Bhaskar Sarkar, Nilesh Jagne, Vishal Mago, Md Quamar Azam
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Abstract

Background: Trauma is among the leading causes of skin loss or degloving. Flaps and skin grafts are common surgical procedures to repair or replace the lost skin over open wounds, and split-thickness skin grafting (STSG) is the most common approach.

Objective: To assess the effect of hyperbaric oxygen therapy (HBOT) on STSG uptake and donor site healing.

Materials and methods: This trial was conducted on patients with traumatic wounds who underwent STSG as per inclusion criteria. The patients were randomized into 2 groups. One group received standard care after skin grafting, and the other received HBOT in addition to standard care. Uptake of STSG was assessed on postoperative day (POD) 4 and POD 7, and donor site healing was assessed on POD 11 and POD 15.

Results: A total of 64 patients aged 18 years to 60 years were included in the study. Mean (standard deviation [SD]) percentage graft uptake on POD 4 was 92.44% (5.98%) in the HBOT group and 88.12% (8.92%) in the control group (P = .036), and on POD 7 was 91.69% (8.71%) in the HBOT group and 83.12% (14.94%) in control group (P = .026). Donor site recovery was also significantly faster in the HBOT group, with a mean (SD) of 15.16 (0.88) days in the HBOT group and 17.97 (2.49) days in the control group (P < .001). In the control group, floating grafts were found in 2 patients, flap necrosis occurred in 4 patients, and 1 patient died due to sepsis, whereas in the HBOT group, significant graft contracture and wound recipient site infection occurred in 1 patient each.

Conclusion: HBOT significantly improved the percentage graft uptake in posttraumatic wounds and resulted in better donor site healing compared with standard care alone.

高压氧治疗对创伤后创面裂厚皮肤移植吸收和供区愈合的影响:一项随机对照试验。
背景:外伤是皮肤脱落或脱手套的主要原因之一。皮瓣和皮肤移植是修复或替换开放性伤口上失去的皮肤的常用手术方法,而裂厚皮肤移植(STSG)是最常用的方法。目的:探讨高压氧治疗(HBOT)对STSG摄取及供区愈合的影响。材料和方法:本试验以创伤性创伤行STSG的患者为研究对象。患者随机分为两组。一组在植皮后接受标准护理,另一组在标准护理的基础上接受HBOT治疗。在术后第4天和第7天评估STSG的摄取情况,在第11天和第15天评估供体部位的愈合情况。结果:共纳入64例患者,年龄18 ~ 60岁。HBOT组对POD 4的平均(标准差[SD])摄取率为92.44%(5.98%),对照组为88.12% (8.92%)(P = 0.036); HBOT组对POD 7的平均(标准差[SD])摄取率为91.69%(8.71%),对照组为83.12% (14.94%)(P = 0.026)。HBOT组的供区恢复也明显更快,平均SD为15.16(0.88)天,对照组为17.97(2.49)天,差异有统计学意义(P < 0.001)。对照组2例出现漂浮移植物,4例出现皮瓣坏死,1例因败血症死亡,而HBOT组各1例出现明显移植物挛缩和创面受者部位感染。结论:与单纯的标准治疗相比,HBOT显著提高了创伤后创面的移植物吸收率,使供区愈合更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.50
自引率
11.80%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.
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