Lo Shu-Fen, Hayter Mark, Chang Chee-Jen, Hu Wen-Yu, Lee Ling-Ling
Department of Nursing, Tzu Chi College of Technology, Buddhist Tzu Chi General Hospital and School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan.
J Clin Nurs. 2008 Aug;17(15):1973-85. doi: 10.1111/j.1365-2702.2007.02264.x.
This paper is a systematic review with the objective of determining the effectiveness of silver-releasing dressing in the management of infected chronic wounds.
Chronic wounds exhibit increased bacterial burdens which not only result in a negative physical impact on patients, impairing their quality of life, but also increase treatment costs. Silver dressings are wound products designed to control and inhibit infection and provide a wound environment conducive to healing. However, there is limited evidence on their effectiveness in doing so.
A systematic review of literature from 1950-May 2007 was conducted using the PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO Host, OCLC, Proquest and PsychInfo databases. The review included randomised or non-randomised control trials, published in English or non-English, of silver-releasing dressings in infected chronic wounds.
Of the over 1957 potentially releasing studies examined, 14 pertinent articles involving 1285 participants were identified. Almost all the participants reported one or more statistically significant outcomes. The main points to emerge from this review of studies are that silver-releasing dressings show positive effects on infected chronic wounds. The quality of the trials was limited by the potential for bias associated with inadequate concealment, no detailed description of the outcome measurement and no reported intention-to-treat analysis. Moreover, problems existed in some studies with confounding factors.
The review clearly highlights the need for well-designed, methodologically standardised outcome measurement research into the effectiveness of silver-releasing dressings. It also points to the need for a comprehensive assessment of wound bed status in further studies.
This review strengthens the case for the use of silver dressings when managing infected chronic wounds. They appear more effective and are tolerated well by patients. However, their use should be accompanied by a comprehensive wound assessment.
本文是一项系统评价，旨在确定含银敷料在感染性慢性伤口处理中的有效性。
慢性伤口的细菌负荷增加，这不仅对患者产生负面的身体影响，损害其生活质量，还会增加治疗成本。银敷料是旨在控制和抑制感染并提供有利于愈合的伤口环境的伤口护理产品。然而，关于其有效性的证据有限。
使用PubMed、CINAHL、Cochrane、MEDLINE、英国护理索引、EBSCO Host、OCLC、ProQuest和PsychInfo数据库对1950年至2007年5月的文献进行系统评价。该评价纳入了以英文或非英文发表的关于含银敷料用于感染性慢性伤口的随机或非随机对照试验。
在审查的超过1957项潜在相关研究中，确定了14篇相关文章，涉及1285名参与者。几乎所有参与者都报告了一项或多项具有统计学意义的结果。本次研究综述得出的主要结论是，含银敷料对感染性慢性伤口显示出积极效果。试验质量受到与隐匿不足相关的偏倚可能性、结局测量无详细描述以及未报告意向性分析的限制。此外，一些研究存在混杂因素问题。
该综述明确强调需要对含银敷料的有效性进行设计良好、方法学标准化的结局测量研究。它还指出在进一步研究中需要对伤口床状态进行全面评估。
本综述强化了在处理感染性慢性伤口时使用银敷料的理由。它们似乎更有效，且患者耐受性良好。然而，使用时应伴有全面的伤口评估。
