Çocuklarda derin kısmi kalınlıktaki yanık yarasının kollajenaz ile enzimatik debridmanı
Küçük Resim Yok
Tarih
2000
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Yanık yaraları Kollajenaz Klostridiopeptidaz A (KKA) ile enzimatik olarak debride edilen 39 olgu ile yanık yarası eksizyonu uygulanan 27 olgu karşılaştırıldı. Olguların tümünde, başvuru esnasındaki yanık yarası derinliği, kısmi kalınlıkta derin yanık (2° derin) olarak belirlenmişti. Otuzdokuz olgunun 25'inde (%64), KKA uygulaması ile, eskar yaradan tamamen uzaklaştırılabildi (Grup D). 14 hastada (%36) ise KKA tedavisi, yarada enfeksiyon gelişmesi ya da greftleme gereksiniminin ortaya çıkması üzerine yarıda kesildi ve bu olgulara teğetsel eksizyon uygulandı (Grup DS). Yanık yaralarının derinlik ve genişliği Grup D ve DS ile benzerlik gösteren ve erken teğetsel eksizyon ile tedavi edilmiş olan 27 olgunun kayıtları ise kontrol grubunu oluşturdu (Grup S). Eskarın yara yüzeyinden tamamen uzaklaştırılabilmesi için geçen süre açısından, gruplar arasında anlamlı bir fark gözlenmedi (sırasıyla ort. 7.4, 7.1 ve 6.9 gün, p>0.05). Grup D'de biri dışında hiçbir olguya kan transfüzyonu gerekmedi. Grup DS'deki olgulara uygulanan cerrahi eksizyon sayısı (ort. 1.14), Grup S'ye göre (ort. l.55) daha az bulundu (p<0.05). Grup D'deki olguların hastanede kalış süresi ise diğer gruplara göre daha kısa bulundu (12.2 gün, p<0.01). Sonuç olarak KKA kullanımı, 2° derin yanıklı olgularda, cerrahi girişime ve kan transfüzyonuna olan gereksinimi azaltmış ve hastanede kalış süresini kısaltmıştır. Bu nedenle, başvuru sırasında, en-fekte olmamış 2° derin yanığı olan çocuklarda KKA, eskarın yaradan uzaklaştırılması için uygulanabilecek bir tedavi seçeneğidir.
Thirty-nine pediatric burn patients treated by enzymatic debridement with Collagenase Clostridiopeptidase A (CCA), were compared to 27 patients whose burn wounds were excised surgically. in all patients, burn wounds were initially assessed as deep partial-thickness during admission. Total removal of eschar was achieved in 25 of 39 (64 %) patients by CCA only (Group D). in 14 patients (36 %), therapy with CCA was ceased because of the development of burn wound infection or a manifest need f or grafting of the wound, therefore, these patients underwent tangential wound excision (Group DS). the records of 27 patients, treated by early tangential excision, having similar burn wounds by extent and depth with Group D and DS were used as controls (Group S). There was no significant difference between the time to achieve a clean wound bed in Group D, DS, and S (mean 7.4, 7.1. and 6.9 days respectively, p>0.05). in Group D, none of the patients required blood transfusion, except one. Patients in Group DS were found to have fewer excisions (mean 1.14) when compared to those in Group S (mean 1.55, p<0.05). the shortest hospital stay was found in Group D (12.2 days, p<0.01). in conclusion, the use of CCA, provided a short hospital stay, reduced the overall need for surgery and blood transfusions, in patients with deep dermal burns. Thus, CCA should be considered as an initial treatment of choice for the removal of eschar in children, having a burn wound without infection, and assessed as deep partial-thickness, at admission.
Thirty-nine pediatric burn patients treated by enzymatic debridement with Collagenase Clostridiopeptidase A (CCA), were compared to 27 patients whose burn wounds were excised surgically. in all patients, burn wounds were initially assessed as deep partial-thickness during admission. Total removal of eschar was achieved in 25 of 39 (64 %) patients by CCA only (Group D). in 14 patients (36 %), therapy with CCA was ceased because of the development of burn wound infection or a manifest need f or grafting of the wound, therefore, these patients underwent tangential wound excision (Group DS). the records of 27 patients, treated by early tangential excision, having similar burn wounds by extent and depth with Group D and DS were used as controls (Group S). There was no significant difference between the time to achieve a clean wound bed in Group D, DS, and S (mean 7.4, 7.1. and 6.9 days respectively, p>0.05). in Group D, none of the patients required blood transfusion, except one. Patients in Group DS were found to have fewer excisions (mean 1.14) when compared to those in Group S (mean 1.55, p<0.05). the shortest hospital stay was found in Group D (12.2 days, p<0.01). in conclusion, the use of CCA, provided a short hospital stay, reduced the overall need for surgery and blood transfusions, in patients with deep dermal burns. Thus, CCA should be considered as an initial treatment of choice for the removal of eschar in children, having a burn wound without infection, and assessed as deep partial-thickness, at admission.
Açıklama
Anahtar Kelimeler
0-Belirlenecek
Kaynak
Pediatrik Cerrahi Derg.
WoS Q Değeri
Scopus Q Değeri
Cilt
14
Sayı
2
