Moffatt Christine J, Edwards Lynfa, Collier Mark, Treadwell Terry, Miller Michael, Shafer Laura, Sibbald Gary, Brassard Alain, McIntosh Andrea, Reyzelman Alex, Price Patricia, Kraus Stacia Merkel, Walters Shelley-Ann, Harding Keith
Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32-8 Uxbridge Road, London, UK.
Int Wound J. 2008 Jun;5(2):267-79. doi: 10.1111/j.1742-481X.2008.00487.x.
This study compared a two-layer (Coban 2 Layer) and a four-layer (Profore) compression bandage system in venous leg ulcer patients. Participants (n = 81) were enrolled into an 8-week, randomised, open-label, ten-centre, crossover clinical trial. The primary endpoint was bandage slippage measured at each dressing change. Secondary endpoints included wound healing, health-related quality of life (HRQoL) and patient preference. Mean slippage estimated from a mixed analysis of variance model (697 visits) was 2.48 cm for the two-layer system and 4.17 cm for the four-layer system (P < 0.001). There were no significant differences in percent of wounds that healed (Fisher's exact test, P = 0.30), in wound area reduction (Wilcoxon rank-sum test, P = 0.88) or in linear healing rate (Wilcoxon rank-sum test, P = 0.94). The HRQoL Physical Symptoms and Daily Living scores were significantly higher with the two-layer system (pooled two-sample t-test, P < 0.05). Patients had a strong preference for the two-layer system (72%) than the four-layer system (22%), with 6% having no preference. In conclusion, the two-layer system exhibited significantly less bandage slippage than the four-layer system. While less bandage slippage did not appear to impact wound healing, there was indication that it may have influenced patient preference in favour of the two-layer system and potentially impacted patients' HRQoL.
本研究比较了两层(柯惠2层)和四层(普洛福)加压绷带系统用于下肢静脉溃疡患者的效果。参与者(n = 81)被纳入一项为期8周的随机、开放标签、十中心交叉临床试验。主要终点是每次换药时测量的绷带滑移情况。次要终点包括伤口愈合、健康相关生活质量(HRQoL)和患者偏好。通过方差分析模型的混合分析(697次访视)估计,两层系统的平均滑移为2.48厘米,四层系统为4.17厘米(P < 0.001)。愈合伤口的百分比(Fisher精确检验,P = 0.30)、伤口面积缩小(Wilcoxon秩和检验,P = 0.88)或线性愈合率(Wilcoxon秩和检验,P = 0.94)方面均无显著差异。两层系统的HRQoL身体症状和日常生活评分显著更高(合并双样本t检验,P < 0.05)。患者对两层系统的偏好(72%)明显高于四层系统(22%),6%无偏好。总之,两层系统的绷带滑移明显少于四层系统。虽然较少的绷带滑移似乎并未影响伤口愈合,但有迹象表明它可能影响了患者对两层系统的偏好,并可能影响了患者的HRQoL。