压力面罩联合支具对烧伤后面部瘢痕的效果比较

doi:10.3969/j.issn.1006-9771.2021.11.005

Abstract

Abstract:

Objective To compare the effects of compression garment combined with orthosis for central face on facial burn scar to compression garment and 3D compression mask.Methods From September, 2016 to June, 2019, 38 facial burn scar patients received compression therapy in Department of Burns and Cutaneous Surgery, the First Affiliated Hospital of Air Force Medical University. According to their preference, they wore compression garment only (CG group, n = 15), compression garment and orthosis for central face (CO group, n = 17) and 3D compression mask (3D group, n = 6) for a year. The facial scar was assessed with Vancouver Scar Scale (VSS) before and after treatment, and the comfort and medical cost was investigated with questionnaire.Results The VSS score decreased after treatment in all the groups (F = 18.49, P < 0.05), while the VSS score was higher in CG group than in CO group (1.717 points, 95%CI 0.925 to 2.482, P < 0.001) and 3D group (1.782 points, 95%CI 0.738 to 2.827, P < 0.001), the difference was less between CO group and 3D group (0.065 points, 95%CI -0.957 to 1.088, P = 1.000). The comfort rate was 60%, 52.9% and 66.7% for CG group, CO group and 3D group, respectively, with no significant difference (P > 0.05). The medical cost was the most for 3D group (12 000 to 16 000 Yuan), and similar for CG group (3000 to 4800 Yuan) and CO group (3300 to 5300 Yuan).Conclusion Compression garment combined with orthosis for central face is more effective on facial burn scar, similar to 3D compression mask, but cheaper than 3D mask, which can be a choice for facial scar patients in developing areas.

Key words: burn, facial scar, rehabilitation, compression garment, orthosis, 3D compression mask

ZHU Chan,HE Lin,WANG Hong-tao,CAI Wei-xia,ZHAO Hai-yang,QI Zong-shi,ZHANG Bo-wen,LIANG Min,YANG Yan-hui,HAN Jun-tao. Effect of Compression Garment Combined with Orthosis on Facial Burn Scar[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1266-1271.

Figures/Tables 4

References 36

[1]	易南, 胡大海, 朱雄翔. 烧伤后增生性瘢痕和瘢痕挛缩的康复处理[J]. 中国康复理论与实践, 2007, 13(10):949-951.
	YI N, HU D H, ZHU X X. Management of the hyperplastic scar and contracture after burn[J]. Chin J Rehabil Theory Pract, 2007, 13(10):949-951.
[2]	朱婵, 朱雄翔, 梁艳艳, 等. 不同手法分区按摩治疗面部瘢痕的效果观察[J]. 中华烧伤杂志, 2015, 31(3):181-182.
	ZHU C, ZHU X X, LIANG Y Y, et al. Chin J Burns, 2015, 31(3):181-182.
[3]	田凌云, 李映兰, 吴英, 等. 压力疗法治疗增生性瘢痕患者有效性的荟萃分析[J]. 中华烧伤杂志, 2019, 35(9):668-675.
	TIAN L Y, LI Y L, WU Y, et al. Meta-analysis of efficacy of pressure therapy in treating patients with hypertrophic scars[J]. Chin J Burns, 2019, 35(9):668-675.
[4]	李曾慧平, 冯蓓蓓, 李奎成. 烧伤后增生性瘢痕压力治疗及相关研究[J]. 中华烧伤杂志, 2010, 26(6):411-415.
	LI-TSANG C W, FENG B B, LI K C. Pressure therapy of hypertrophic scar after burns and related research[J]. Chin J Burns, 2010, 26(6):411-415.
[5]	PRASAM M L, HORODYSKI M, SCHNEIDER P S, et al. Comparison of skin pressure measurements with the pelvic circumferential compression devices on pelvic ring injuries[J]. Injury, 2016, 47(7):17-20.
[6]	ROGERS B, CHAPMAN T, RETTELE J, et al. Computerized manufacturing of transparent face masks for the treatment of facial scarring[J]. J Burn Care Rehabil, 2003, 24(2):91-96. doi: 10.1097/01.BCR.0000054171.82007.7A
[7]	刘苗, 方方, 王雪, 等. 烧伤治疗与康复用压力服的认知现状[J]. 纺织学报, 2015, 36(11):121-126.
	LIU M, FANG F, WANG X, et al. Cognitive status analysis of burn treatment and rehabilitation pressure suits[J]. J Text Res, 2015, 36(11):121-126.
[8]	RIVERS E A, STRATE R G, SOLEM L D. The transparent face mask[J]. Am J Occup Ther, 1979, 33(2):108-113.
[9]	沈小鹏, 李东. 瘢痕防治及其研究进展[J]. 中华临床医师杂志(电子版), 2019, 13(6):463-467.
	SHEN X P, LI D. Progress in scar prevention and treatment[J]. Chin J Clin (Electronic Ed), 2019, 13(6):463-467.
[10]	马显杰, 李威扬, 刘超华, 等. 面部烧伤后瘢痕的美学整复策略及疗效[J]. 中华烧伤杂志, 2016, 32(8):469-473.
	MA X J, LI W Y, LIU C H, et al. Aesthetic reconstruction strategy for postburn facial scar and its clinical effect[J]. Chin J Burns, 2016, 32(8):469-473.
[11]	黄振, 郑大伟, 张旭阳, 等. 小颗粒脂肪注射在面部增生性瘢痕治疗中的应用[J]. 中华整形外科杂志, 2019, 35(4):381-385.
	HUANG Z, ZHENG D W, ZHANG X Y, et al. Application of micro fat injection in the treatment of facial hypertrophic scar[J]. Chin J Plast Surg, 2019, 35(4):381-385.
[12]	纪雪亮, 王意, 蓝蔚, 等. 压力治疗对烧伤后增生性瘢痕的远期影响[J]. 中国康复医学杂志, 2016, 31(5):521-525.
	JI X L, WANG Y, LAN W, et al. A study on long-term effects of pressure therapy on hypertrophic scar after burns[J]. Chin J Rehabil Med, 2016, 31(5):521-525.
[13]	刘伟源, 许贤君, 陈燕图. 增生性瘢痕的生物学基础和药物应用的研究进展[J]. 中国美容医学, 2018, 27(8):151-154.
	LIU W Y, XU X J, CHEN Y T. Advances on the biological basis and the application of drugs in hypertrophic scar[J]. Chin J Aesthet Med, 2018, 27(8):151-154.
[14]	夏照帆, 吕开阳. 中国临床瘢痕防治专家共识[J]. 中华损伤与修复杂志(电子版), 2017, 12(6):401-408.
	XIA Z F, LÜ K Y. Chin J Injury Rep Wound Heal (Electronic Ed), 2017, 12(6):401-408.
[15]	卫雪, 胡鹏, 周健, 等. 面动脉穿支皮瓣修复瘢痕性下睑外翻[J]. 中华整形外科杂志, 2021, 37(4):399-404.
	WEI X, HU P, ZHOU J, et al. Facial artery perforator flap in repairing lower eyelid cicatricial ectropion[J]. Chin J Plast Surg, 2021, 37(4):399-404.
[16]	蔡景龙. 瘢痕防治的历史与现状[J]. 中华损伤与修复杂志(电子版), 2017, 12(4):241-246.
	CAI J L. History and current situation of scar prevention and treatment[J]. Chin J Injury Rep Wound Heal (Electronic Ed), 2017, 12(4):241-246.
[17]	JODIE W, MEGAN S, ROY K, et al. Variability of pressure at the pressure garment-scar interface in children after burn: a pilot longitudinal cohort study[J]. Burns, 2019, 45(1):103-113. doi: 10.1016/j.burns.2018.08.029
[18]	SAURABH M, REBECCA C, LARRY M J, et al. Survey of national and local practice of compression therapy timing for burn patients in the United States[J]. Burns, 2019, 45(6):1215-1222. doi: 10.1016/j.burns.2018.12.016
[19]	于震峰. 压力治疗对烧伤后增生性瘢痕的远期影响分析[J]. 中国医药指南, 2019, 17(9):36-37.
	YU Z F. Guide Chin Med, 2019, 17(9):36-37.
[20]	魏亚婷, 付晋凤, 李曾慧平. 儿童面部烧伤瘢痕的压力治疗研究进展[J]. 中华烧伤杂志, 2017, 33(5):277-280.
	WEI Y T, FU J F, LI-TSANG C W. Advances in the research of pressure therapy for pediatric burn patients with facial scar[J]. Chin J Burns, 2017, 33(5):277-280.
[21]	LI-TSANG C W, FENG B, HUANG L, et al. A histological study on the effect of pressure therapy on the activities of myofibroblasts and keratinocytes in hypertrophic scar tissues after burn[J]. Burns, 2015, 41(5):1008-1016. doi: 10.1016/j.burns.2014.11.017
[22]	胡大海, 易南, 朱雄翔. 实用烧伤康复治疗学[M]. 北京: 人民卫生出版社, 2016: 95-114.
	HU D H, YI N, ZHU X X. Practical Burn Rehabilitation Therapeutics [M]. Beijing: People's Medical Publishing House, 2016: 95-114.
[23]	ENGRAV L H, HEIMBACH D M, RIVARA F P, et al. 12-year within-wound study of the effectiveness of custom pressure garment therapy[J]. Burns, 2010, 36(4):975-983. doi: 10.1016/j.burns.2010.04.014
[24]	LIUZZI F, CHADWICK S, SHAH M. Pediatric postburn scar management in the UK: a national survey[J]. Burns, 2015, 41(2):252-256. doi: 10.1016/j.burns.2014.10.017
[25]	VAN BUENDIA L B, ALLELY R R, LASSITER R, et al. What's behind the mask? A look at blood no changes with prolonged facial pressure and expression using laser Doppler image[J]. J Burn Care Res, 2010, 31(3):441-447. doi: 10.1097/BCR.0b013e3181db5250
[26]	刘悦, 王连召. 瘢痕综合治疗的临床实践与思考[J]. 中华整形外科杂志, 2020, 36(10):1069-1074.
	LIU Y, WANG L Z. Clinical practice and thinking of comprehensive scar treatment[J]. Chin J Plast Surg, 2020, 36(10):1069-1074.
[27]	吴桂焕, 伍国维, 钟世祥, 等. 低温热塑板矫形器结合压力衣对上肢烧伤后瘢痕挛缩畸形的干预和矫治[J]. 医学理论与实践, 2021, 34(1):166-167.
	WU G H, WU G W, ZHONG S X, et al. J Med Theory Prac, 2021, 34(1):166-167.
[28]	孔长庚, 吴多庆, 符林雄, 等. 热塑板材支具外固定与石膏外固定治疗Colles骨折:随机对照试验[J]. 中国组织工程研究, 2019, 23(22):3469-3474.
	KONG C G, WU D Q, FU L X, et al. External fixation of thermoplastic plate brace versus gypsum for treating Colles fracture: a randomized controlled trial[J]. J Chin Rehabil Tis Eng Res, 2019, 23(22):3469-3474.
[29]	朱琳怡, 张子凤, 傅育红, 等. 拇指指腹缺损岛状皮瓣移植术后早期压力疗法的效果[J]. 中国康复理论与实践, 2018, 24(5):610-614.
	ZHU L Y, ZHANG Z F, FU Y H, et al. Effect of early pressure therapy on island skin flap for vital of thumb ventral[J]. Chin J Rehabil Theory Pract, 2018, 24(5):610-614.
[30]	胡大海, 易南. 烧伤康复技术现状与展望[J]. 中华烧伤杂志, 2014, 30(6):469-471.
	HU D H, YI N. Current situation and prospect of measures of rehabilitation after burn injury[J]. Chin J Burns, 2014, 30(6):469-471.
[31]	ATIYEH B S, EL KHATIB A M, DIBO S A. Pressure garment therapy (PGT) of burn scars: evidence-based efficacy[J]. Ann Burns Fire Disasters, 2013, 26(1):205-212.
[32]	严刚, 谢丽华, 李武全, 等. 透明面具治疗面部增生性瘢痕43例[J]. 中华烧伤杂志, 2010, 26(6):427-429.
	YAN G, XIE L H, LI W Q, et al. Chin J Burns, 2010, 26(6):427-429.
[33]	COLLA C, KANT S B, VAN DEN KERCKHOVE E, et al. Manual fabrication of a specialized transparent facial pressure mask: a technical note[J]. Prosthet Orthot Int, 2019, 43(3):356-360. doi: 10.1177/0309364618820141
[34]	KANT S B, COLLA C, VAN DEN KERCKHOVE E, et al. Clinical effects of transparent facial pressure masks: a literature review[J]. Prosthet Orthot Int, 2019, 43(3):349-355. doi: 10.1177/0309364619836023
[35]	HE H, GAO M ILLÉS B, et al. 3D Printed and electrospun, transparent, hierarchical polylactic acid mask nanoporous filter[J]. Int J Bioprint, 2020, 6(4):278.
[36]	WEI Y, WANG Y, ZHANG M, et al. The application of 3D-printed transparent facemask for facial scar management and its biomechanical rationale[J]. Burns, 2018, 44(2):453-461. doi: 10.1016/j.burns.2017.08.006

组别	n	性别(男/女, n)	年龄(岁)	致伤原因 (火焰烧伤/烫伤/化学烧伤, n)	瘢痕大小 (%TBSA)
压力面罩组	15	8/7	31.5±11.2	9/4/2	1.1±0.3
联合组	17	10/7	30.3±10.6	11/4/2	1.0±0.2
3D组	6	3/3	32.2±12.2	3/2/1	1.0±0.3

组别	n	治疗前	治疗后
组别	n	治疗前	未校正	校正
压力面罩组	15	11.52±1.31	5.93±1.03	5.87±0.22
联合组	17	11.31±1.33	4.12±0.99	4.15±0.21
3D组	6	11.23±1.22	4.00±0.89	4.08±0.35

组别	n	无明显不适	轻微不适	明显舒适	舒适度
压力面罩组	15	9	5	1	60.0%
联合组	17	9	6	2	52.9%
3D组	6	4	2	0	66.7%
P₁值					0.840
P₂值					0.300
P₃值					0.300

Effect of Compression Garment Combined with Orthosis on Facial Burn Scar

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