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便携式一次性负压伤口治疗设备在低至中度渗液伤口家庭护理患者中的应用:病例系列

Use of a portable, single-use negative pressure wound therapy device in home care patients with low to moderately exuding wounds: a case series.

作者信息

Hurd Theresa, Trueman Paul, Rossington Alan

机构信息

Nursing Practice Solutions, Ontario, Canada.

Smith and Nephew, Hull, United Kingdom; email:

出版信息

Ostomy Wound Manage. 2014 Mar;60(3):30-6.

Abstract

Negative pressure wound therapy (NPWT) is widely used in the management of acute and chronic wounds. The purpose of this 8-week study was to evaluate outcomes of using a new canisterless, portable, single-use NPWT system in patients with wounds treated in a Canadian community healthcare setting. The device is designed to provide negative pressure at 80±20 mm Hg, 24 hours a day of continuous usage, for a maximum wear time of 7 days. Data on wound outcomes, including exudate levels, wound appearance, and wound area, were collected weekly by a Registered Nurse as part of routine practice. When treatment was discontinued, patients and nurses were asked to rate their satisfaction with the device. Data from patients who had used a conventional NPWT device to manage their wounds were retrospectively abstracted from their medical records. In the prospective study, conducted between October 2011 and July 2012, 326 patients (median age=61 years; range 17-91 years) with wounds of mixed etiology (53 pressure ulcers, 21 venous leg ulcers, 16 diabetic foot ulcers, and 15 traumatic and 221 surgical wounds) were treated for a maximum of 8 weeks with the portable NPWT device. The majority of patients (228 out of 326; 68%) achieved complete wound closure within 8 weeks of treatment. The Kaplan-Meier estimate of median time to healing of all wounds was 9 weeks. The majority of patients (318 patients, 97%) reported they were pleased or satisfied with the dressing performance. Nurses indicated satisfaction with the dressing performance for all but two patients (99%). The majority (89%) of patients managed with conventional NPWT (n=539) had an open surgical wound with moderate or high levels of exudate. Healing rates in the portable and conventional NPWT group were similar (10% to 11% per week). Portable, single-use NPWT has the potential to deliver good wound outcomes in community care settings and simplify the use of negative pressure for nurses and patients. Additional research is needed to evaluate treatment efficacy and cost effectiveness.

摘要

负压伤口治疗(NPWT)广泛应用于急性和慢性伤口的处理。这项为期8周的研究旨在评估在加拿大社区医疗环境中,使用一种新型无罐、便携式、一次性NPWT系统治疗伤口的患者的治疗效果。该设备设计为每天24小时持续使用,提供80±20毫米汞柱的负压,最长佩戴时间为7天。作为常规操作的一部分,注册护士每周收集伤口相关数据,包括渗出液水平、伤口外观和伤口面积。当治疗结束时,要求患者和护士对该设备的满意度进行评分。使用传统NPWT设备处理伤口的患者的数据是从他们的病历中回顾性提取的。在2011年10月至2012年7月进行的前瞻性研究中,326例病因混合的伤口患者(中位年龄=61岁;范围17 - 91岁)(53例压疮、21例下肢静脉溃疡、16例糖尿病足溃疡、15例创伤性伤口和221例手术伤口)使用便携式NPWT设备进行了最长8周的治疗。大多数患者(326例中的228例;68%)在治疗8周内实现了伤口完全愈合。所有伤口愈合的中位时间的Kaplan-Meier估计值为9周。大多数患者(318例,97%)表示对敷料性能满意或高兴。除两名患者外,护士对所有患者的敷料性能都表示满意(99%)。使用传统NPWT治疗的大多数患者(89%,n = 539)有开放性手术伤口,渗出液水平为中度或高度。便携式和传统NPWT组的愈合率相似(每周10%至11%)。便携式一次性NPWT有潜力在社区护理环境中实现良好的伤口治疗效果,并简化护士和患者对负压的使用。需要进一步的研究来评估治疗效果和成本效益。

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