Department of Reconstructive and Aesthetic Plastic Surgery, University of Turin, San Giovanni Battista Hospital, Turin, Italy.
Int Wound J. 2011 Oct;8(5):492-9. doi: 10.1111/j.1742-481X.2011.00821.x. Epub 2011 Aug 9.
Wounds can be caused by different mechanisms and have a significant morbidity and mortality. Negative pressure wound therapy (NPWT) is one of the most successful treatment modalities for wound healing. We have been using both foam and gauze-based NPWT. During application of NPWT, we noticed that the patient's pain was of varying intensity depending on the filler used. The aim of our work was to compare the level of pain and feedback before, during the treatment and at the dressing change after treatment with NPWT with two different fillers. For this study, we compared a pool of 13 gauze-treated patients with a pool of 18 foam-treated patients regarding the level of pain and feedback before, during the treatment and at the dressing change after treatment with NPWT. They were all post-traumatic patients with loss of tissue up to the muscular band. The patients were asked to respond to a questionnaire interviewed by the same physician to assess the level of pain using VNS (verbal numerical scale). We observed similar difference of means before and during the treatment with NPWT with gauze and foam. Regarding the pain at the dressing change, the mean of the scores for the foam was 6·5 while for the gauze was 4·15. In this case, we noticed the most significant difference between means from the scores given: 2·35 which was a statistically significant difference between the two groups (P = 0·046). The finding of this study confirms less pain at the dressing change after treatment with gauze-based NPWT. In our opinion, this finding is related to the more adhesive property of the foam probably because of the ingrowth of the granulation tissue in the micropores present on the foam. Considering this statement, we recommend the foam for neuropathic and paraplegic patients and the gauze for patients with bone and tendon exposition wounds, patients that do not tolerate NPWT with foam and low compliant patient particularly paediatric and old-age patients. We remind that the performance of this study was not sponsored by any company.
伤口可由不同的机制引起，具有显著的发病率和死亡率。负压伤口治疗（NPWT）是促进伤口愈合最成功的治疗方法之一。我们一直使用泡沫和纱布基 NPWT。在应用 NPWT 时，我们注意到患者的疼痛强度因使用的填充物而异。我们的工作目的是比较使用两种不同填充物的 NPWT 治疗前后的疼痛程度和反馈。在这项研究中，我们比较了一组 13 名接受纱布治疗的患者和一组 18 名接受泡沫治疗的患者，比较了 NPWT 治疗前后的疼痛程度和反馈。他们都是创伤后患者，组织损失到肌肉带。患者被要求对同一位医生进行的问卷调查做出回应，以使用 VNS（言语数字量表）评估疼痛程度。我们观察到在 NPWT 治疗前后使用纱布和泡沫时，均值差异相似。关于换药时的疼痛，泡沫的平均得分为 6.5，而纱布的平均得分为 4.15。在这种情况下，我们注意到两组之间的得分差异最大：2.35，这是两组之间的统计学显著差异（P = 0.046）。这项研究的结果证实了基于纱布的 NPWT 治疗后换药时疼痛减轻。在我们看来，这一发现与泡沫的粘性更强有关，可能是因为肉芽组织在泡沫上的微孔中的生长。考虑到这一说法，我们建议对神经病变和截瘫患者使用泡沫，对有骨和肌腱暴露伤口、不能耐受泡沫 NPWT 的患者以及顺应性差的患者，特别是儿科和老年患者使用纱布。我们提醒，这项研究的实施没有得到任何公司的赞助。
