采用含龙胆紫和亚甲蓝的抗菌泡沫敷料治疗下肢慢性伤口的病例系列研究。
Case series of lower-extremity chronic wounds managed with an antibacterial foam dressing bound with gentian violet and methylene blue.
机构信息
Patricia M. Coutts, RN, IIWCC (Toronto), is a Wound and Clinical Trials Coordinator, and Judy Ryan, RN, is a Nurse, both at Toronto Regional Wound Healing Clinic, Mississauga, Ontario, Canada. R. Gary Sibbald, BSc, MD, MEd, FRCPC(Med Derm), MACP, FAAD, MAPWCA, is Professor of Public Health and Medicine, University of Toronto, Toronto, Ontario, Canada; Director, International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care), Dalla Lana School of Public Health, University of Toronto; Past President, World Union of Wound Healing Societies; and Clinical Editor, Advances in Skin & Wound Care, Philadelphia, Pennsylvania. Ms Coutts has disclosed that she is a consultant to and member of the speakers' bureau for Hollister Limited. Ms Ryan has disclosed that she has no financial relationships related to this article. Dr Sibbald has disclosed that his employer, the University of Toronto, is the recipient of an unconditional educational grant from Hollister Inc, research grants from Healthpoint Biotherapeutics, Systagenix, and Exiton, and was the recipient of research grants from the Government of Ontario, 3M, BSN, CIDA, Coloplast,Covidien, Gaymar, KCI, Johnson & Johnson, Registered Nurses Association of Ontario, Mölnlycke, Hollister Limited, Valeant, Shire, Galderma, Leo, Stiefel, Abbott, and Mississauga Halton Community Care Access Center; he is a board member of 3M, BSN, Coloplast, Covidien, Gaymar, KCI, Systagenix, Mölnlycke, Registered Nurses Association of Ontario, Hollister Limited, Healthpoint Biotherapeutics, Valeant, and Shire Regenerative Medicine; and he is a member of the speakers' bureau for 3M, BSN, Coloplast, Gaymar, KCI, Systagenix, Mölnlycke, Hollister, Valeant, Shire Regenerative Medicine, Galderma, Leo, and Stiefel Laboratories, Inc. This study was sponsored by an unrestricted educational grant from Hollister Limited, distributors of Hydrofera Blue. Submitted November 26, 2013; accepted in revised for
出版信息
Adv Skin Wound Care. 2014 Mar;27(3 Suppl 1):9-13. doi: 10.1097/01.ASW.0000443270.71030.71.
OBJECTIVE
To evaluate an antibacterial dressing for the management of lower-extremity chronic wounds with critical colonization.
DESIGN
A case series of n = 15 patients with lower-extremity chronic wounds were treated with an antibacterial foam dressing consisting of polyvinyl alcohol (PVA) foam bound with gentian violet and methylene blue (Hydrofera Blue; Hydrofera, LLC, Willimantic, Connecticut).
SETTING
An outpatient clinic in Ontario, Canada.
PATIENTS
The dressing was applied to diabetic foot ulcers (n = 8) and other venous/leg wound etiologies (n = 7). The study population was clinically challenging due to high mean body weight, extended wound durations, and high diabetes prevalence.
MAIN OUTCOME MEASURES
Wounds were assessed for clinical signs of superficial and deep/surrounding bacterial burden using the validated NERDS and STONEES mnemonic and with semiquantitative bacterial swabs. Changes in wound size, pain, and other clinical parameters were also recorded.
MAIN RESULTS
Improvements in surface critical colonization and pain score at the end of the study period were noted in some patients, especially in patients with diabetic foot ulcers. A decreasing wound size was observed in 8 of the 14 patients (57%) at week 4. One patient was excluded from wound size change analysis.
CONCLUSIONS
An antibacterial foam dressing consisting of PVA foam bound with gentian violet and methylene blue showed encouraging results in a clinically challenging study population. This dressing may be a suitable option for lower-extremity chronic wounds demonstrating an increased superficial bacterial burden. Further investigation focused on identifying the characteristics of patients who are most responsive to the dressing is warranted.
目的
评估一种用于治疗下肢慢性伤口伴临界定植的抗菌敷料。
设计
对 15 例下肢慢性伤口患者进行了一项病例系列研究，这些患者使用了一种由聚乙烯醇（PVA）泡沫与龙胆紫和亚甲蓝结合而成的抗菌泡沫敷料（Hydrofera Blue；Hydrofera，LLC，Willimantic，Connecticut）。
设置
加拿大安大略省的一家门诊诊所。
患者
敷料应用于糖尿病足溃疡（n=8）和其他静脉/腿部伤口病因（n=7）。由于平均体重高、伤口持续时间长和糖尿病高发，研究人群具有临床挑战性。
主要观察指标
使用经过验证的 NERDS 和 STONEES 记忆法以及半定量细菌拭子评估伤口的浅表和深部/周围细菌负荷的临床体征。还记录了伤口大小、疼痛和其他临床参数的变化。
主要结果
在研究结束时，一些患者（尤其是糖尿病足溃疡患者）的表面临界定植和疼痛评分有所改善。在 14 例患者中的 8 例（57%）在第 4 周时观察到伤口大小减小。1 例患者被排除在伤口大小变化分析之外。
结论
由聚乙烯醇泡沫与龙胆紫和亚甲蓝结合而成的抗菌泡沫敷料在具有临床挑战性的研究人群中显示出令人鼓舞的结果。这种敷料可能是一种适合治疗表现出浅表细菌负荷增加的下肢慢性伤口的选择。需要进一步研究，重点是确定对敷料反应最敏感的患者的特征。
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