Modern approaches to treatment of superficial dermal burns
Objective. The aim of the study is improving the treatment’s effectiveness in patients with superficial dermal burns due to the usage of modern wound dressings.
Materials and methods. Under observation were 150 patients with superficial dermal thermal lesions with an area of 5-30 % of the body surface aged 10-64 years, who were treated at the Kyiv City Clinical Hospital № 2 during 2016-2019. The main group consisted of 120 patients, whose burn’s treatment provided under wound dressings in a humid environment (hydrogel, spongy polyurethane foam, film coatings). Comparison group – 30 patients whose wounds were treated by applying wet-drying bandages or bandages with water-soluble antibacterial ointments.
Results and discussion. At the beginning of the treatment, the pH of the wound content of dermal burns was 7.9-8.1. On the 3rd day of treatment in patients of the main group, the pH of wounds under wound dressings was defined as acidic (5.7). In patients of the comparison group on the 3rd and 4th day the pH of the wounds was determined as alkaline, and only on the 6th day it became slightly acidic. As the pH of the wounds increased, the rate of healing decreased. In the phase of acute inflammation and exudation, the pH of superficial dermal burns was alkaline 7.8-8.2, in the proliferation phase, under the wound coverings – acidic (5.5-4.1). The use of wound dressings led to a decrease in the number of microbial association in patients to 1.1±0.4 on 9-11th days after injury, the colonization of wound surfaces changed slightly to 3×102 per 1 g. In contrast, in patients of the comparison group in the sequestration period of superficial necrotic scab increased the number of microbial associates to 2.8±0.7, wound colonization increased to 105 per 1 g of tissue. The time of epithelialization with the use of wound dressings was 13.8±1.7 days, in patients of another group – 19.4±2.5 days.
Conclusions. Wound dressings that keep the wound moist are an effective way to influence the wound process, which can be regulated. In the treatment of superficial dermal burns under wound dressings there is a change of the alkaline reaction to acidy, which stimulates wound healing. Wound management in a wet closed chamber changes the qualitative and quantitative composition of the wound microflora, reduces the microbial contamination of burn wounds by two orders of magnitude. Superficial dermal burns heal under wound dressings for 13.8 days against 19.4 in traditional treatment.
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