Ulus Travma Acil Cerrahi Derg. 2009; 15(2): 135-140

Büyük çaplý yanýklarý bulunan hastalarda konvansiyonel tedaviye karþý biyolojik pansuman: Klinik çalýþma

Seyed Nejat Hosseini¹, Seyed Nouraddin Mousavinasab², Haleh Rahmanpour³, Mojtaba Fallahnezhad^2
1Zanjan Üniversitesi Týp Fakültesi, Yanýk Bölümü, Zanjan, Ýran
²Zanjan Üniversitesi Týp Fakültesi, Toplum Týbbý, Zanjan, Ýran
³Zanjan Üniversitesi Týp Fakültesi, Obstetriks Ve Jinekoloji Bölümü, Zanjan, Ýran

AMAÇ: Yýllardan beri yanýklar, iyileþme elde edilinceye kadar serum fizyolojikle ýslatýlmýþ pansumanlarla günlük olarak tedavi edilmiþtir. Günümüzde, yaralar greft teknikleri yoluyla veya sentetik ve biyolojik pansumanlar kullanýlarak kapatýlmaktadýr. Bu yazýda, geliþmekte olan ülkelerde biyolojik pansuman kullanýmý ile ilgili daha az deneyim ve ilgi bulunmasý nedeniyle, büyük çaplý yanýklarý bulunan hastalarda konvansiyonel tedaviye karþý biyolojik sargýlarýn tedavi sonucu karþýlaþtýrýldý. GEREÇ-YÖNTEM: Ekim 2002 ile Haziran 2006 tarihleri arasýnda, alev veya haþlanma yoluyla %30 ile %75 arasýndaki oranlarda total vücut yüzeyi alaný (TVYA) yanýðý oluþan 118 hasta incelemeye alýndý. Hastalar iki gruba ayrýldý; konvansiyonel tedavide olan birinci grup (n=53), biyolojik pansuman (Xenoderm) ile tedavi edilen ikinci grup (n=65). BULGULAR: Konvansiyonel grup ile biyolojik pansuman grubundaki mortalite oranlarý sýrasýyla 19 (%35) ve 7 (%10,8) olarak bulundu (p=0,001). Ortalama hastanede kalma süresi 31,3 güne karþý 18,2 gün ve pansuman sayýsý 22,1’e karþý 9,9 oldu (p=0,0005). SONUÇ: Bu çalýþma sonucunda, biyolojik pansuman (Xenoderm) daha iyi bir sonuç ve daha düþük bir mortalite oraný vermiþtir. Bununla birlikte, ameliyat sayýsý ile ince kalýnlýkta deri grefti gereksiniminin azalmasýný karþýlaþtýran randomize bir klinik çalýþma yapýlmasý gerekmektedir.

Anahtar Kelimeler: Biyolojik pansuman, yanýklar/cerrahi; büyük çaplý yanýk; domuz derisi; Xenoderm.

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A biological dressing versus ‘conventional’ treatment in patients with massive burns: a clinical trial

Seyed Nejat Hosseini¹, Seyed Nouraddin Mousavinasab², Haleh Rahmanpour³, Mojtaba Fallahnezhad^2
1Department Of Burns, Zanjan University Medical Sciences, Zanjan, Iran
²Department Of Social Medicine, Zanjan University Medical Sciences, Zanjan, Iran
³Department Of Obstetrics And Gynecology, Zanjan University Medical Sciences, Zanjan, Iran

BACKGROUND: For many years, burns were treated by daily saline-soaked dressings until the burns healed primarily. Today, wounds are closed via grafting techniques, or by using synthetic and biological dressings. Due to less experience and interest in the use of biological dressing in developing countries, the aim of this study was to compare the outcome of biological dressings versus ‘conventional’ treatment in patients with massive burns. METHODS: One hundred eighteen patients with total body surface area (TBSA) burns of 30% to 75%, by flame or scalds, were investigated from October 2002 to June 2006. The patients were divided into two groups. Those in the first group received conventional treatment (n=53) and those in the second group (n=65) received treatment with a biological dressing (Xenoderm). RESULTS: Mortality rates in the conventional group and biological group were 19 (35%) and 7 (10.8%), respectively (p=0.001). The mean hospital stay was 31.3 days vs 18.2 days and the number of dressings was 22.1 vs 9.9, respectively (p=0.0005). CONCLUSION: The results of this study indicate that a biological dressing (Xenoderm) gave a better outcome and lower mortality. However, a randomized clinical trial that compares the number of operations and decreasing need for split thickness skin grafts is warranted.

Keywords: Biological dressing, burns/surgery; massive burns; pig skin; Xenoderm.

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