Clinical study on the treatment of second degree scald in infants with porcine acellular dermal matrix combined with silk fibroin excipients

objective To evaluate the effect of porcine acellular dermal matrix combined with silk fibroin in treating second degree scald in children. Methods 104 patients with Ⅱ degree burn were randomly divided into the control group (silk dressing) and the experimental group (porcine decellularized dermal matrix plus silk dressing) , by random number table, with 52 patients in each group. The statistical differences in the frequency of dressing change, time of complete scab dissolution, vancouver score, wound infection, healing time, inflammation around the wound, wound exudate score and pain were compared between the two groups. Continuous variables were expressed as ±s, the difference between two groups were compared by two-samples t-test, the difference between before and after treatment were compared by pared-samples t-test; categorical variables were expressed as percentage and compared by chi-square test. The difference of pain score was tested by Z-test. Result The number of dressing changes (2.87±0.98) , time of complete scab dissolution (8.26±3.18) d and vancouver score (4.25±0.87) of the experimental group were significantly lower than those of the control group (5.64±1.02) , (12.38±3.02) d and (8.12±1.04) (t = 14.121, 6.775, 20.582, P < 0.001) . The wound infection rate (0.00 %) , the healing time (8.53+1.49) d of patients with shallow Ⅱ degree were significantly lower in the experimental group than those in the control group (17.31%) , (10.61±2.05) (χ2 = 9.853, P = 0.002, t = 5.918, P < 0.001) . Deep Ⅱ degree wound infection rate (5.77 %) and the healing time (12.90±1.64) were significantly lower in the experimental group than in the control group (34.62 %) , (15.45±1.49) (χ2 = 13.425, P = 0.000, t = 8.299, P < 0.001) . After treatment, the inflammation score (1.91±0.48) and wound exudate score (2.86±0.45) of the experimental group were significantly higher than those of the control group (1.33±0.37) and (2.09±0.53) (t = 6.901, 7.986, P < 0.001) . The pain score of the experimental group was lower than that of the control group (Z = 41.657, P < 0.001) . Conclusions The effect of xenogeneic acellular dermal matrix combined with silk protein dressing in the treatment of children with second degree scald was remarkable. It could reduce the infection and recovery time after operation,promote recover, reduce pain, and have obvious therapeutic advantages. Key words: Xenogenic acellular dermal matrix; Silk protein; Wound dressing; Second degree scald; Clinical efficacy