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Topkin®—Eine resorbierbare Folie aus Lactid-Caprolacton

Kinische Anwendung als Wundabdeckung

  • Unfallchirurgie
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Die resorbierbare Folie Topkin® (Fa. Biomet-Merck), welche aus einem Kopolymer aus D,L-Lactid und ε-Caprolacton besteht, wurde bei 71 Spalthautentnahmewunden und 42 Spalthautempfängerbezirken als Wundabdeckung eingesetzt. Die Größe der Spalthautentnahmewunden betrug bis zu 900 cm2, die Ausdehnung der konditionierten Hautweichteildefekte bis 1200 cm2. Zum Vergleich wurden 29 Empfängerbezirke mit Fettgazeverbänden versorgt. Die Schmerzhaftigkeit der Behandlung wurde auf einer visuellen Analogskala (0–100) gemessen und die Zeitdauer für die Verbandswechsel registriert. Bei den Spalthautentnahmewunden kam es zu 2 Komplikationen (Nachblutung, lokale Infektion). Im Bereich der Spalthautempfängerbezirke traten in 5 Fällen lokale Komplikationen auf (1 überschießende Granulation, 2 verbliebene Restdefekte, 1 lokaler Infekt sowie 1 Schorfbildung). Bei 29 Patienten, deren Spalthautempfängerbezirke mit herkömmlichen Fettgazeverbänden behandelt wurden, wurden 8 Wundheilungsstörungen (4 Restdefekte, 3 oberflächliche Transplantatnekrosen und 1 lokaler Infekt) beobachtet. Bei 4 Wunden wurden deutliche Narbenbildungen beobachtet. Die Zeit der Wundheilung bei der Behandlung mit resorbierbarer Folie und Fettgazeverbänden war nicht signifikant unterschiedlich. Die maximale Schmerzhaftigkeit der Folienbehandlung betrug bei den Spalthautentnahmewunden 10,9, bei den kontaminierten Wunden 2,9. Der pflegerische Aufwand für die Wundbehandlung betrug bei den ersten 20 Patienten 4 min/Tag, nach Änderung des Regimes bei den weiteren durchschnittlich 2 min/Tag.

Abstract

The resorbable film Topkin (Biomet-Merck), which consists of a copolymer composed of D,D-lactide and ε-caprolactone was applied to 71 split skin donor sites and 42 split skin grafting sites as wound coverage. The split skin donor sites had an area of up to 900 cm2, and the recipient soft tissue defects covered up to 1200 cm2. For comparison 29 grafting sites were covered with grease gauze dressings. In the split skin donor sites, there were two complications (hematoma, local infection). In split skin grafting sites five complications (one hypertrophic granulation, two residual defects, one local infection, and one scar formation) were observed. Of the 29 patients whose split skin grafting sites were treated with conventional grease gauze bandages, 8 experienced wound healing problems (four residual defects, three superficial graft necroses, and one local infection). Substantial scarring was observed in four wounds. There was no significant difference in wound healing time between treatment with the film and treatment with grease gauze. The maximal pain ratings during the film treatment was 10.9 for the split skin donor sites and 2.9 for the contaminated wounds. Time expenditure for care of the wounds was 4 min/day in the first 20 patients and, after modification of the regime, 2 min/day in the remaining patients.

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Porté, T., Faschingbauer, M., Seide, K. et al. Topkin®—Eine resorbierbare Folie aus Lactid-Caprolacton. Trauma Berufskrankh 5, 443–448 (2003). https://doi.org/10.1007/s10039-003-0811-3

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