ZHANG Xiaowei, ZHANG Zheng, ZHANG Wenjuan, LI Bin, YU Dongping, LI Jiake, ZHANG Quanxi, BAI Hailiang, YANG Shuxu, CAO Weihua, ZOU Xiaofang
Objective To systematically compare the effects of four types of dressings on long-term scar quality of deep second-degree burn wounds after enzymatic debridement. Methods A total of 125 patients with deep second-degree burns who were hospitalized in the Burn Department of Characteristics Medical Center of PLA Air Force from January 2019 to December 2024 were retrospectively included and divided into four groups according to the dressing type used after enzymatic debridement: Suprathel group (group A, 32 cases), MepilexAg group (group B, 28 cases), Mepitel group (group C, 35 cases), and Jelonet group (group D, 30 cases). The primary outcome measure was scar elasticity (R2) at 12 months, and secondary indicators included transepidermal water loss (TEWL), melanin index, scar thickness, wound healing time, pain score, Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (POSAS), and SF-36 quality of life score. Results At 12 months, the scar elasticity R2 in group A (0.79±0.09) was significantly superior to that in group D (0.69±0.11) , and the difference was statistically significant (P=0.009). The TEWL [(10.8±2.8) g/(m2·h)], melanin index (165.2±24.5) and scar thickness (1.35±0.28) mm in group A were lower than those in group D (14.2±3.5)g/(m2·h), (185.6±29.1), (1.72±0.36) mm, and the differences were statistically significant (P<0.05).The wound healing time [(13.2±3.1)d], number of dressing changes [(2.5±1.0)times] and pain score [(3.0±1.0)points] were also superior to those in group D (15.8±3.9 days, 11.5±2.6 times, 4.8±1.5 points), and the differences were statistically significant (P<0.05). At 12 months, group A showed significantly better VSS total score 2.0 (1.0, 4.0), POSAS patient total score 12.0 (9.0, 15.0) and SF-36 PCS (78.5±8.2) compared with the group D 4.0 (3.0, 6.0), 18.0 (14.0, 21.0), (71.5±9.6), and the differences were statistically significant (P<0.05). Groups B and C were better than Group D, but the differences were not statistically significant. Conclusions After enzymatic debridement, the application of synthetic membrane dressings Suprathel in deep second-degree burn wounds may be superior to other types of dressings in improving long-term scar quality.