King Alice, Stellar Judith J, Blevins Anne, Shah Kara Noelle
Pediatric Advanced Wound and Skin Services, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio. ; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
Department of Nursing, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
Adv Wound Care (New Rochelle). 2014 Apr 1;3(4):324-334. doi: 10.1089/wound.2013.0477.
The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moisture-associated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations.
为儿科患者提供的医疗和外科护理日益复杂,这使得他们面临出现压疮、手术伤口不愈合以及与潮湿相关的皮肤损伤等并发症的重大风险。目前,新生儿和儿科患者的伤口护理实践,包括特定敷料或其他伤口护理产品的选择,是基于医护人员的经验和偏好,以及少数基于专家意见发布的临床指南;这些人群缺乏严格的循证临床伤口管理指南。对伤口愈合病理生理学认识的进展促使专门的伤口护理产品数量不断增加,其中大多数主要面向成年患者销售,且尚未在新生儿和儿科人群中进行安全性和有效性评估。本综述旨在讨论在这些人群中使用更传统的伤口护理产品和更新的伤口护理技术的现有数据,包括医用级蜂蜜、纳米晶银和软硅胶基粘合剂技术。应建立循证伤口护理实践,并证明现有伤口护理敷料和产品在新生儿和儿科人群中的安全性、有效性及合理使用,以解决这些人群伤口管理的具体问题。制定和实施针对新生儿和儿科人群常见伤口治疗的循证指南至关重要。除了评估目前在成年人群中使用的市售伤口护理敷料和产品外,还应评估更新的伤口护理技术在新生儿和儿童中的应用。此外,有必要进一步研究新生儿和儿童伤口愈合的具体病理生理学,以促进开发适用于这些人群的伤口护理敷料和产品。