Lenselink E, Andriessen A
Medical Center Haaglanden, Den Haag, The Netherlands.
J Wound Care. 2011 Nov;20(11):534, 536-9. doi: 10.12968/jowc.2011.20.11.534.
This cohort study evaluated the clinical efficacy of a polyhexanide-containing biocellulose dressing, Suprasorb X+PHMB (Lohmann & Rauscher GmbH), for the eradication of biofilms in non-healing wounds. Polyhexanide (PHMB) has been shown to have microbicidal activity when applied to chronic wounds and burns.
Twenty-eight patients, aged over 18 years, who presented at an outpatient wound clinic with non-healing locally infected and/or critically colonised wounds of various aetiologies that showed clinical signs of biofilm were included in the study. Sixteen patients (nine females), with a mean age of 60.9±21.6 years, were included in the analysis. The patients were prospectively followed for a maximum of 24 weeks or until healing for analysis of safety and efficacy endpoints. Evolution of wound size was conducted with tracings and standardised digital photographs as well as for determining healing rates.
At 24 weeks,12 wounds (75%) had healed (complete epithelialisation with no drainage). Of those wounds that had not closed, the mean wound area had reduced by 61% at week 24. Ten patients (63%) had a good reduction of the biofilm, five (32%) scored moderate and one (6%) had no reduction noted at week 24. The mean percentage of granulation tissue had increased significantly (p<0.04) when comparing day 0 (38%) with week 24 (77%). Yellow tissue present in the wound bed decreased (p<0.01): 62% (day 0) versus 23% (week 24). All patients reported reduced pain after dressing change.
The results suggest that continuous application of PHMB, using a biocellulose wound dressing, reduced biofilm in the stagnating wounds treated, thus promoting healing. The treatment was comfortable, safe and reduced wound pain at dressing change. The PHMB-containing biocellulose dressing seems to be suitable for lightly to moderately exuding wounds.
This study was supported by a scientific grant from Lohmann & Rauscher.
本队列研究评估了含聚己缩胍的生物纤维素敷料Suprasorb X+PHMB（罗曼&劳斯彻有限公司）对清除不愈合伤口生物膜的临床疗效。聚己缩胍（PHMB）已被证明应用于慢性伤口和烧伤时具有杀菌活性。
28例年龄超过18岁的患者被纳入研究，这些患者在门诊伤口诊所就诊，患有各种病因的不愈合局部感染和/或严重定植伤口，且有生物膜的临床体征。16例患者（9名女性）被纳入分析，平均年龄为60.9±21.6岁。对患者进行前瞻性随访，最长24周或直至伤口愈合，以分析安全性和疗效终点。通过绘图、标准化数码照片以及确定愈合率来观察伤口大小的变化。
在24周时，12个伤口（75%）已愈合（完全上皮化且无渗液）。在未愈合的伤口中，到第24周时平均伤口面积减少了61%。10例患者（63%）的生物膜有明显减少，5例（32%）为中度减少，1例（6%）在第24周时无减少。与第0天（38%）相比，第24周时肉芽组织的平均百分比显著增加（p<0.04）。伤口床中黄色组织减少（p<0.01）：第0天为62%，第24周为23%。所有患者均报告换药后疼痛减轻。
结果表明，使用生物纤维素伤口敷料持续应用PHMB可减少所治疗的停滞伤口中的生物膜，从而促进愈合。该治疗方法舒适、安全，且换药时可减轻伤口疼痛。含PHMB的生物纤维素敷料似乎适用于轻度至中度渗液的伤口。
本研究得到了罗曼&劳斯彻公司的科研资助。
