在克什米尔山谷社会经济地位较低的患者中，评估低成本定制负压伤口治疗（VAC疗法）与传统伤口敷料在治疗下肢难愈合溃疡方面的效果。

Evaluation of low-cost custom made VAC therapy compared with conventional wound dressings in the treatment of non-healing lower limb ulcers in lower socio-economic group patients of Kashmir valley.

作者信息

Ali Zameer, Anjum Afshan, Khurshid Lubna, Ahad Hamayun, Maajid Saheel, Dhar Shabir Ahmad

机构信息

Department of Orthopaedics SKIMS Medical College, Bemina, Srinagar, 190018, Jammu and Kashmir, India.

出版信息

J Orthop Surg Res. 2015 Dec 10;10:183. doi: 10.1186/s13018-015-0314-5.

DOI:10.1186/s13018-015-0314-5

PMID:26654318

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4674953/

Abstract

BACKGROUND

Negative-pressure wound therapy is a technique to achieve wound healing in patients with non-healing wounds of the lower limb; vacuum-assisted closure (VAC) therapy is a technique to accelerate the healing of non-healing ulcers that fail to heal on their own (primary healing) (Plast Reconstr Surg 117:193-209S, 2006). Delayed wound healing or non-healing of ulcers is a significant health problem, particularly in older adults. The efficacy of VAC dressings has been demonstrated in several randomized controlled studies, which have shown significantly faster wound healing rates compared to conventional wound therapy (Lancet 366:1704-10, 2005; J Wound Care 17:426-32, 2008). However, commercially available VAC is costly. The aim of using custom made VAC was decided by our team due to lower socio-economic status of patients taken for study who could not have afforded charges of commercially available VAC unit.

OBJECTIVE

Objective was to evaluate VAC therapy compared with conventional dressings in the treatment of non-healing lower limb ulcers in lower socio-economic patients.

METHODS

Sixty patients of lower socio-economic status aged between 40 and 70 were prospectively studied for non-healing ulcers Wagner grade 2 or 3 and randomized into 2 groups. VAC dressing was kept for over a period of 2-7 weeks. Ulcers were treated until the wound closed spontaneously, surgically or until completion of the 50-day period, whichever was earlier.

RESULTS

By seventh week, discharge disappeared in 96 % in VAC and only 54 % in conventional dressing group. Granulation tissue appeared in 100 % of patients in VAC group and only 63 % in conventional dressing group. The patients treated with VAC dressing in our study showed comparable wound reduction capabilities with an average wound size reduction of 56 % in comparison to conventional dressing group which had average wound size reduction of 29 %. Majority of wounds in VAC group got closed in 7 weeks. Patient satisfaction was excellent in the majority of patients in VAC group compared to those in conventional dressing group.

CONCLUSION

The application of VAC™ had shown good results in our study.

摘要

背景

负压伤口治疗是一种促进下肢难愈合伤口患者伤口愈合的技术；真空辅助闭合（VAC）疗法是一种加速自行愈合失败（一期愈合）的难愈合溃疡愈合的技术（《整形与重建外科》117:193 - 209S，2006年）。伤口愈合延迟或溃疡不愈合是一个重大的健康问题，在老年人中尤为突出。VAC敷料的疗效已在多项随机对照研究中得到证实，这些研究表明，与传统伤口治疗相比，伤口愈合速度明显更快（《柳叶刀》366:1704 - 1710，2005年；《伤口护理杂志》17:426 - 432，2008年）。然而，市售的VAC成本高昂。由于本研究纳入的患者社会经济地位较低，无力承担市售VAC设备的费用，我们团队决定使用定制的VAC。

目的

评估VAC疗法与传统敷料相比，对社会经济地位较低的下肢难愈合溃疡患者的治疗效果。

方法

前瞻性研究60例年龄在40至70岁之间、社会经济地位较低的Wagner 2级或3级难愈合溃疡患者，并将其随机分为2组。VAC敷料使用2至7周。对溃疡进行治疗，直至伤口自行闭合、通过手术闭合或直至50天疗程结束，以先达到者为准。

结果

到第7周时，VAC组96%的渗出消失，而传统敷料组仅为54%。VAC组100%的患者出现肉芽组织，而传统敷料组仅为63%。在我们的研究中，接受VAC敷料治疗的患者伤口缩小能力相当，平均伤口大小缩小56%，而传统敷料组平均伤口大小缩小29%。VAC组的大多数伤口在7周内闭合。与传统敷料组相比，VAC组的大多数患者对治疗的满意度很高。