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一项随机对照试验,旨在研究一种新型超氧化溶液治疗糖尿病足术后广泛创面的疗效和安全性。

A randomized controlled trial to examine the efficacy and safety of a new super-oxidized solution for the management of wide postsurgical lesions of the diabetic foot.

作者信息

Piaggesi A, Goretti C, Mazzurco S, Tascini C, Leonildi A, Rizzo L, Tedeschi A, Gemignani G, Menichetti F, Del Prato S

机构信息

Department of Endocrinology and Metabolism Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

出版信息

Int J Low Extrem Wounds. 2010 Mar;9(1):10-5. doi: 10.1177/1534734610361945.

Abstract

This randomized trial was done to test the effectiveness and safety of using a novel antiseptic solution (Dermacyn(R) Wound Care [DWC], Oculus Innovative Sciences, Petaluma, CA) in the management of the postoperative lesions on the infected diabetic foot. 40 patients with postsurgical lesions wider than 5 cm2 left open to heal by secondary intention were randomized into 2 groups. Group A was locally treated with DWC, whereas group B received povidone iodine as local medication, both in adjunct to systemic antibiotic therapy and surgical debridement if needed. Ischemia, renal failure, bilateral lesions, or immunodepression were considered as exclusion criteria. Patients were followed up weekly for 6 months. The primary endpoint was healing rate at 6 months, while secondary endpoints were healing time, time to achieve negative cultures, duration of antibiotic therapy, number of reinterventions, and adverse events. Healing rates at 6 months were significantly shorter in group A (90%) than in group B (55%; P < .01). The time taken for cultures to become negative and duration of antibiotic therapy were also significantly (P < .05) shorter in group A than in group B, whereas the number of reinterventions was significantly higher in group B (P < .05). No difference was noted in the adverse events except that for reinfections, which were more frequent in group B than in group A (P < .01). DWC is as safe as and more effective than standard local antiseptics in the management of wide postsurgical lesions in the infected diabetic foot.

摘要

本随机试验旨在测试一种新型抗菌溶液(Dermacyn®伤口护理液[DWC],Oculus创新科学公司,加利福尼亚州佩塔卢马)用于处理感染性糖尿病足术后伤口的有效性和安全性。40例术后伤口面积大于5 cm2且采用二期愈合的患者被随机分为两组。A组采用DWC局部治疗,而B组采用聚维酮碘作为局部用药,两组均辅以全身抗生素治疗,并根据需要进行手术清创。缺血、肾衰竭、双侧病变或免疫抑制被视为排除标准。对患者进行为期6个月的每周随访。主要终点为6个月时的愈合率,次要终点为愈合时间、培养转阴时间、抗生素治疗持续时间、再次干预次数及不良事件。A组6个月时的愈合率(90%)显著高于B组(55%;P <.01)。A组培养转阴所需时间和抗生素治疗持续时间也显著短于B组(P <.05),而B组的再次干预次数显著高于A组(P <.05)。除再感染外,两组不良事件无差异,B组的再感染发生率高于A组(P <.01)。在处理感染性糖尿病足的大面积术后伤口时,DWC与标准局部抗菌剂一样安全且更有效。

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