Bateman Sharon Dawn
Nurse Practitioner, Specialist in Tissue Viability, South Tees NHS Hospitals Foundation Trust.
Br J Nurs. 2015;24(12):S24-9. doi: 10.12968/bjon.2015.24.Sup12.S24.
The development and subsequent deterioration of diabetic foot ulceration (DFU) is a common occurrence across all healthcare divides, concerning all patient groups, age, gender and social environments. It increases demand on clinical resources and creates unnecessary hardship for patients. Chronic DFU is challenging to prevent and notoriously difficult to manage owing to the complex nature of the patient and the disease itself. The improvement of oxygenation to many chronic wound groups is gaining momentum across wound care; particularly in those wounds such as DFU that present with circulatory, oxygen-deficient scenarios.
A descriptive evaluation was undertaken in an acute clinical setting where a spray solution containing purified haemoglobin was used in a cohort of 20 patients who presented with chronic (>12 weeks) DFU. Standard wound care was undertaken by 18 health professionals with no changes to products, devices or practice before evaluation. All wounds received the addition of the product on eight set occasions over a 4-week period and the resulting data correlated in regards to the set outcomes of wound surface area reduction, ease of use, adverse events and patient acceptability.
At 4 weeks all wounds had demonstrated positive wound reduction, there were no adverse events, all patients and clinicians found the product acceptable and easy to use. Interestingly, although not a set outcome, all wounds commenced the evaluation with wound-bed slough present and at 4 weeks 100% were deemed slough free. At a further 4-week review no patients wounds had regressed.
The incorporation of a haemoglobin spray solution within this cohort of DFU resulted in a positive improvement in wound healing and slough elimination. Further work in this area is recommended to increase the evidence.
糖尿病足溃疡(DFU)的发生及随后的恶化在所有医疗环境中都很常见,涉及所有患者群体、年龄、性别和社会环境。它增加了对临床资源的需求,给患者带来了不必要的痛苦。由于患者和疾病本身的复杂性,慢性DFU难以预防且 notoriously难以管理。改善许多慢性伤口组的氧合在伤口护理领域正获得越来越多的关注;特别是在那些如DFU等存在循环、缺氧情况的伤口中。
在急性临床环境中进行了一项描述性评估,在一组20例患有慢性(>12周)DFU的患者中使用了含有纯化血红蛋白的喷雾溶液。在评估前,由18名卫生专业人员进行标准伤口护理,产品、设备或操作均无变化。在4周内的八个特定时间点,所有伤口都添加了该产品,并将所得数据与伤口表面积减少、易用性、不良事件和患者可接受性等设定结果相关联。
在4周时,所有伤口均显示伤口面积有积极减少,无不良事件发生,所有患者和临床医生都认为该产品可接受且易于使用。有趣的是,尽管这不是一个设定的结果,但所有伤口在评估开始时都有伤口床腐肉存在,而在4周时100%被认为无腐肉。在进一步的4周复查中,没有患者的伤口出现恶化。
在这组DFU患者中加入血红蛋白喷雾溶液导致伤口愈合和腐肉消除方面有积极改善。建议在该领域开展进一步工作以增加证据。