Wolcott Randall D
Southwest Regional Wound Care Center, Lubbock, TX; email:
Wounds. 2012 May;24(5):132-7.
Although excessive exudate has been associated with poor wound healing outcomes, exudate is still not well understood in the pathophysiology of chronic wounds. Wound exudate is believed to be the result of wounds that are trapped in a persistent, hyper inflammatory state. Biofilm, bacteria of multiple species living in community, has multiple well-defined molecular pathways that produce hyper inflammation. The exudate that is produced in wounds is a potentially important nutrient source for biofilm; therefore, rapidly removing exudate may rob the biofilm of important nutrients and suppress its negative effects.
A hydroconductive fiber dressing that possesses excellent capillary action properties was utilized to rapidly remove wound exudate in 10 patients.
The data demonstrate an average 62% reduction in wound volume for these 10 wounds over a 4-week period. Two wounds completely closed during the 2 weeks, and all but 1 wound significantly improved. Only 6 of the 10 wounds showed fewer bacteria at the end of the 4-week study period, suggesting there is not a 1:1 correlation with reduction in the number of bacteria in the wound and wound healing.
Rapid removal of the nutrient source from wound biofilm, while not diminishing the number of bacteria, may suppress a biofilm's negative effects on wound healing. .
尽管过多的渗出液与伤口愈合不良的结果相关，但在慢性伤口的病理生理学中，渗出液仍未得到充分理解。伤口渗出液被认为是陷入持续高炎症状态的伤口的结果。生物膜，即生活在群落中的多种细菌，具有多种明确的产生高炎症的分子途径。伤口中产生的渗出液是生物膜潜在的重要营养来源；因此，快速清除渗出液可能会剥夺生物膜的重要营养物质并抑制其负面影响。
使用具有出色毛细作用特性的导水纤维敷料快速清除10例患者伤口的渗出液。
数据表明，在4周的时间里，这10个伤口的体积平均减少了62%。2个伤口在2周内完全愈合，除1个伤口外，所有伤口均有显著改善。在4周的研究期结束时，10个伤口中只有6个伤口的细菌数量减少，这表明伤口细菌数量的减少与伤口愈合之间不存在1:1的相关性。
从伤口生物膜中快速清除营养源，虽然不会减少细菌数量，但可能会抑制生物膜对伤口愈合的负面影响。
