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一项针对创伤性截瘫患者压疮负压伤口治疗创新设备的非随机对照临床试验。

A non-randomised, controlled clinical trial of an innovative device for negative pressure wound therapy of pressure ulcers in traumatic paraplegia patients.

作者信息

Srivastava Rajeshwar N, Dwivedi Mukesh K, Bhagat Amit K, Raj Saloni, Agarwal Rajiv, Chandra Abhijit

机构信息

Department of Orthopaedic Surgery, King George's Medical University (KGMU), Lucknow, India.

Department of Surgical Gastroenterology, King George's Medical University (KGMU), Lucknow, India.

出版信息

Int Wound J. 2016 Jun;13(3):343-8. doi: 10.1111/iwj.12309. Epub 2014 Jun 3.

Abstract

The conventional methods of treatment of pressure ulcers (PUs) by serial debridement and daily dressings require prolonged hospitalisation, associated with considerable morbidity. There is, however, recent evidence to suggest that negative pressure wound therapy (NPWT) accelerates healing. The commercial devices for NPWT are costly, cumbersome, and electricity dependent. We compared PU wound healing in traumatic paraplegia patients by conventional dressing and by an innovative negative pressure device (NPD). In this prospective, non-randomised trial, 48 traumatic paraplegia patients with PUs of stages 3 and 4 were recruited. Patients were divided into two groups: group A (n = 24) received NPWT with our NPD, and group B (n = 24) received conventional methods of dressing. All patients were followed up for 9 weeks. At week 9, all patients on NPD showed a statistically significant improvement in PU healing in terms of slough clearance, granulation tissue formation, wound discharge and culture. A significant reduction in wound size and ulcer depth was observed in NPD as compared with conventional methods at all follow-up time points (P = 0·0001). NPWT by the innovative device heals PUs at a significantly higher rate than conventional treatment. The device is safe, easy to apply and cost-effective.

摘要

通过连续清创和每日换药治疗压疮(PU)的传统方法需要长期住院,且伴有相当高的发病率。然而,最近有证据表明负压伤口治疗(NPWT)可加速愈合。用于NPWT的商业设备价格昂贵、笨重且依赖电力。我们比较了创伤性截瘫患者使用传统敷料和一种创新负压设备(NPD)治疗PU伤口的愈合情况。在这项前瞻性、非随机试验中,招募了48例患有3期和4期PU的创伤性截瘫患者。患者分为两组:A组(n = 24)使用我们的NPD接受NPWT,B组(n = 24)接受传统换药方法。所有患者均随访9周。在第9周时,所有使用NPD的患者在PU愈合方面,在腐肉清除、肉芽组织形成、伤口引流和培养方面均显示出统计学上的显著改善。与传统方法相比,在所有随访时间点,NPD组的伤口大小和溃疡深度均显著减小(P = 0·0001)。创新设备的NPWT治疗PU的愈合速度明显高于传统治疗。该设备安全、易于应用且具有成本效益。

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