Verdú Soriano José, Nolasco Bonmati Andreu
Departamento de Enfermeria Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante.
Rev Enferm. 2010 Oct;33(10):6-14.
This study was conducted with the objective to assess, in real clinical conditions in primary care and geriatric centers, application and utility of nanocrystalline silver dressings dressings combined with hydrocellular in relation to the development during 20 shifts dressing or complete healing of the characteristics of the lesions included in the study
Prospective observational multicenter open, repeated measures. It could include injuries of different etiologies (pressure ulcers stage 11-111, lower limb and traumatic wounds or surgical origin), with clinical signs of local infection (at least three of the following: redness, purulent discharge, heat, edema and pain). Only one wound was included per patient. An analysis of effectiveness by intention to treat all lesions included.
We recruited 103 patients who met the inclusion criteria but were collected in which 77 patients were used for nanocrystalline silver dressings in some phase of the study, They had a median of 80 years of age and 58.4% were women. By type of injury: 53.2% pressure ulcers, 31.2% lower extremity ulcers and 14.3% traumatic or surgical wounds. Over 50% of the lesions was older than eight months and a larger area of 22.75 cm2. At first, 70.1% had redness, purulent discharge 64.9%, 37.7% heat edema 42.9% and 65.8% pain. Remained in the study a median of 42.5 days at a rate of change of dressing every 2.5. During this time in 96.1% of the lesions were removed for clinical signs of local infection in a statistically significant (p < or = 0.001). 27.3% healed from injuries and those not healed, 92.9% experienced improvement, and its healing curves were statistically significant (p < 0.05). 92.2% of clinicians assessed treatment with these products as good or excellent.
The use of the products used in this study consistent with the concept and PLH TIME, has proved useful in this type of injury reducing the clinical signs of infection, promoting granulation tissue and necrotic removing the burden being able to manage the exudate of an optimal healing and getting one out of three masses.
本研究旨在评估在初级保健和老年医学中心的实际临床条件下，纳米晶银敷料与水凝胶敷料联合使用对于研究中所纳入损伤在20次换药期间的发展或完全愈合的应用情况及效用。
前瞻性观察性多中心开放、重复测量研究。研究对象可包括不同病因的损伤（II - III期压疮、下肢创伤性伤口或手术源性伤口），伴有局部感染的临床体征（至少具备以下三项：发红、脓性分泌物、发热、水肿和疼痛）。每位患者仅纳入一处伤口。对所有纳入损伤按意向性治疗进行有效性分析。
我们招募了103名符合纳入标准的患者，但最终纳入研究的有77名患者在研究的某些阶段使用了纳米晶银敷料，他们的年龄中位数为80岁，女性占58.4%。按损伤类型：53.2%为压疮，31.2%为下肢溃疡，14.3%为创伤性或手术伤口。超过50%的损伤病程超过8个月，且面积较大，为22.75平方厘米。起初，70.1%的损伤有发红症状，64.9%有脓性分泌物，37.7%发热，42.9%有水肿，65.8%有疼痛。研究期间的中位数为42.5天，换药频率为每2.5天一次。在此期间，96.1%的损伤因局部感染的临床体征而被去除，具有统计学意义（p≤0.001）。27.3%的损伤愈合，未愈合的损伤中，92.9%有改善，其愈合曲线具有统计学意义（p < 0.05）。92.2%的临床医生对使用这些产品的治疗效果评价为良好或优秀。
本研究中使用的产品符合PLH TIME概念，已证明对这类损伤有用，可减少感染的临床体征，促进肉芽组织生长，清除坏死组织，能够处理渗出液以实现最佳愈合，并使三分之一患者痊愈。
