Zimny S, Schatz H, Pfohl U
EVK Bethesda, Medizinische Klinik I, Duisburg, Germany.
Diabet Med. 2003 Aug;20(8):622-5. doi: 10.1046/j.1464-5491.2003.01011.x.
The application of felted foam is a promising method for plantar pressure reduction in the ulcer region of diabetic foot ulcers, but knowledge of its effects on wound healing is sparse. The objective of this study was to evaluate the effects of felted foam on wound healing in diabetic foot ulcers compared with a standard method of plantar pressure relief.
A total of 54 Type 1 or Type 2 diabetic patients with neuropathic diabetic foot ulcers were evaluated in this prospective randomized controlled study. Ulcer healing was assessed by planimetric measurement of the wound area at beginning of the study and after 10 weeks and at least until wound healing. The patients were consecutively enrolled in the study; 24 patients were randomized to the felted foam therapy, and 30 patients were randomized to conventional therapy.
In the felted foam group, the initial average wound area was 102.3 +/- 45.3 mm2 (mean +/- sd), and 5.4 +/- 3.1 mm2 after 10 weeks with an average healing time of 75 days [95% confidence interval (CI) 67-84]. In the conventional therapy group, the initial average wound area was 112.5 +/- 50.8 mm2, and 10.6 +/- 4.2 mm2 after 10 weeks with an average healing time of 85 days (95% CI 79-92) (P = 0.03). The mean wound radius decreased by 0.48 mm (95% CI 0.42-0.56) per week in the felted foam group and by 0.39 mm (95% CI 0.35-0.42) per week in the conventional group (P = 0.005).
The felted foam technique appears to be at least as effective as conventional plantar ulcer treatment. It may be a useful alternative in treating neuropathic foot ulceration, especially in patients who are not able to avoid weight-bearing reliably.
应用毡状泡沫材料是一种有望降低糖尿病足溃疡溃疡区域足底压力的方法，但关于其对伤口愈合影响的了解却很少。本研究的目的是评估与标准足底减压方法相比，毡状泡沫材料对糖尿病足溃疡伤口愈合的影响。
在这项前瞻性随机对照研究中，共评估了54例1型或2型患有神经性糖尿病足溃疡的患者。通过在研究开始时、10周后以及至少直至伤口愈合时对伤口面积进行平面测量来评估溃疡愈合情况。患者连续纳入研究；24例患者随机接受毡状泡沫材料治疗，30例患者随机接受传统治疗。
在毡状泡沫材料组中，初始平均伤口面积为102.3±45.3平方毫米（均值±标准差），10周后为5.4±3.1平方毫米，平均愈合时间为75天[95%置信区间（CI）67 - 84]。在传统治疗组中，初始平均伤口面积为112.5±50.8平方毫米，10周后为10.6±4.2平方毫米，平均愈合时间为85天（95%CI 79 - 92）（P = 0.03）。毡状泡沫材料组伤口平均半径每周减少0.48毫米（95%CI 0.42 - 0.56），传统治疗组每周减少0.39毫米（95%CI 0.35 - 0.42）（P = 0.005）。
毡状泡沫材料技术似乎至少与传统足底溃疡治疗方法一样有效。它可能是治疗神经性足部溃疡的一种有用替代方法，特别是对于那些无法可靠避免负重的患者。
