wIRA適用於嚴重燒傷的兒童

wIRA for severely burned children

Study of the Children’s Hospital
Park Schönfeld, Kassel, Department of
Pediatric Surgery

A prospective, randomized, controlled, double-blind study with 45 severely burned children was carried out at the Children’s Hospital Park Schönfeld, Kassel, Germany. 30 minutes irradiation was applied once a day (starting on the first day, with the day of burn being day 1). In the group with wIRA and visible light VIS (wIRA(+VIS), appro-ximately 75% wIRA, 25% VIS) a markedly faster reduction of wound size was seen in comparison to a control group with only VIS. On the fifth day (after 4 days with irradi-ation), the decision was taken as to whether surgical debridement of necrotic tissue was necessary because of deeper (second degree, type b) burns (11 of 21 in the group with wIRA, 14 of 24 in the control group) or whether non-surgical treatment was possible (second degree, type a burns). The patients treated conservatively were kept within the study and irradiated until reepi-thelialisation was complete.
The patients in the group with wIRA showed a markedly faster reduction of wound area: a median reduction of wound size of 50% was reached already after 7 days compared to 9 days in the control group, a median reduc-tion of wound size of 90% was already achieved after 9 days compared to 13 days in the control group, see Figure 10 and Figure 11. After 9 days, the median reduc-tion in wound area was 89.2% versus 49.5%, the median difference between the groups was a 39.5% reduction of the wound area (99% confidence interval 34.4%/43.0%), p=0.000011. The median difference between the groups existed already after one day with p=0.00013 and after 2, 5, 6, 7, 8, 9, 10 and 11 days with p<0.0001. In addi-tion, the group with wIRA showed superior results in terms of the overall surgical assessment of the wound and the assessment of effects of irradiation (the latter as a trend up to 3 months after the burn) compared to the control group [2].

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