Matiasek J, Djedovic G, Mattesich M, Morandi E, Pauzenberger R, Pikula R, Verstappen R, Pierer G, Koller R, Rieger U M
Department of Plastic, Aesthetic and Reconstructive Surgery, Wilhelminenspital, Vienna, Austria.
J Wound Care. 2014 Nov;23(11):590, 592-6. doi: 10.12968/jowc.2014.23.11.590.
Effective wound bed preparation is an essential element in the healing of chronic wounds, including pressure ulcers (PUs). Negative pressure wound therapy (NPWT) reduces oedema, stimulates the formation of granulation tissue and helps remove wound exudate. This helps prepare the wound bed for secondary healing, skin grafting or coverage with flaps. Combining NPWT with an instillation phase using an antiseptic (octenidine based) irrigation solution is a novel approach to PU management. Three patients with Category 4 gluteal PUs were treated with NPWT and instillation fluid, following surgical debridement of necrotic tissue. The aim was to achieve optimal wound bed preparation prior to wound closure by local fasciocutaneous flap. The antiseptic efficacy of octenilin wound irrigation solution in microorganism eradication was quantified by in vitro tests simulating real conditions using leg ulcer vacuum exudates. All wounds completely healed after four weeks, and no adverse incidents occurred due to instillation of octenidine. No recurrence of the PU occurred during a one year follow-up.
有效的伤口床准备是慢性伤口愈合的关键要素，包括压疮（PU）。负压伤口治疗（NPWT）可减轻水肿，刺激肉芽组织形成，并有助于清除伤口渗出物。这有助于为二期愈合、皮肤移植或皮瓣覆盖准备伤口床。将NPWT与使用防腐剂（基于奥替尼啶）冲洗液的灌注阶段相结合是一种治疗PU的新方法。对3例4级臀部长压疮患者在手术清创坏死组织后采用NPWT和灌注液进行治疗。目的是在通过局部筋膜皮瓣闭合伤口之前实现最佳的伤口床准备。通过使用腿部溃疡真空渗出物模拟实际情况的体外试验，对奥替尼林伤口冲洗液在根除微生物方面的抗菌效果进行了量化。所有伤口在4周后完全愈合，且未因奥替尼啶灌注发生不良事件。在一年的随访期间，压疮未复发。
