Stansby G, Wealleans V, Wilson L, Morrow D, Gooday C, Dhatariya K
Freeman Hospital, Newcastle upon Tyne, UK.
J Wound Care. 2010 Nov;19(11):496, 498-502. doi: 10.12968/jowc.2010.19.11.79706.
The primary aim of this pilot observational study was to assess the reduction in wound depth and area achieved with a new negative pressure wound therapy (NPWT) system in diabetic patients with foot ulcers and post-amputation wounds. Secondary aims were to assess pain levels, extent of exudate removal, and ease of use of the system for both the patient and care giver.
Patients in both acute and home care settings were enrolled into this 4-week study. Dressings were changed three times per week. Wound area and depth, exudate removal and pain severity were evaluated at each dressing change. At the final visit, the investigators and patients were surveyed with respect to equipment and dressings used in the study.
Sixteen patients were enrolled into the study. Data relating to 14 patients with a variety of post-amputation wounds were included in the intention-to-treat (ITT) analysis. The post-amputation wounds showed a general trend for a reduction in the median wound surface area between baseline (22.9cm2; range 0.5-55) and the final visit (15.3cm2; range 2.4-63.5). This equates to a median change (calculated from the percentage change in wound area for each patient individually) of -41% (range -82% to +15%). There was also a general trend in reduction in the median depth between baseline (17mm; range 0-35) to final visit (5mm; range 0-35). One patient presented with a foot ulcer that demonstrated a 50% reduction in depth from baseline to the final assessment. The device effectively managed wound exudate and most patients reported low pain levels during therapy. Ease of use of the system was rated very highly by investigators and patients.
This pilot study indicates that the use of the new NPWT system can be expected to have a positive effect on the healing of post-amputation wounds and foot ulcers in patients with diabetes. The findings demonstrate that the system is easy to use, effectively controls exudate and minimises pain and inconvenience for patients being treated with NPWT.
This study was sponsored by Mölnlycke Heath Care (Gothenburg, Sweden) and Medela AG (Baar, Switzerland). The authors have no other conflicts of interest that are directly relevant to the content of this manuscript.
这项初步观察性研究的主要目的是评估一种新型负压伤口治疗(NPWT)系统对糖尿病足溃疡和截肢后伤口患者伤口深度和面积的减少情况。次要目的是评估疼痛程度、渗出物清除程度以及该系统对患者和护理人员的易用性。
急性和家庭护理环境中的患者均纳入这项为期4周的研究。每周更换三次敷料。每次更换敷料时评估伤口面积和深度、渗出物清除情况以及疼痛严重程度。在最后一次随访时,就研究中使用的设备和敷料对研究者和患者进行调查。
16名患者纳入研究。意向性分析(ITT)纳入了14名患有各种截肢后伤口患者的数据。截肢后伤口显示出从基线(22.9平方厘米;范围0.5 - 55)到最后一次随访(15.3平方厘米;范围2.4 - 63.5)中位伤口表面积减少的总体趋势。这相当于中位变化(根据每位患者伤口面积的百分比变化单独计算)为 - 41%(范围 - 82%至 + 15%)。从基线(17毫米;范围0 - 35)到最后一次随访(5毫米;范围0 - 35)中位深度也有总体减少趋势。一名患有足部溃疡的患者从基线到最终评估深度减少了50%。该设备有效管理伤口渗出物,大多数患者在治疗期间报告疼痛程度较低。研究者和患者对该系统的易用性评价很高。
这项初步研究表明,使用新型NPWT系统有望对糖尿病患者截肢后伤口和足部溃疡的愈合产生积极影响。研究结果表明该系统易于使用,有效控制渗出物,并将接受NPWT治疗患者的疼痛和不便降至最低。
本研究由莫林医疗保健公司(瑞典哥德堡)和美德乐股份公司(瑞士巴尔)赞助。作者没有其他与本手稿内容直接相关的利益冲突。