Ondieki J G, Khainga S O, Owilla F, Nangole F W
Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.
East Afr Med J. 2012 Jul;89(7):230-40.
Wounds have provided a challenge to the clinicians for centuries and this scenario persists to the 21st century. Negative pressure wound therapy (NPWT) is one of the latest additions in wound management. It has been widely adopted in developed countries with foam as the default wound dressing although it has some limitations.
To determine the difference in outcomes between the use of gauze versus foam as wound dressing in NPWT for the management of acute traumatic wounds with soft tissue loss.
Prospective randomised comparative interventional study.
Kenyatta National Hospital Orthopaedic and Surgical wards.
All patients aged above 12 years with Class III and Class IV acute traumatic wounds.
The main outcome measure is the time taken to achieve 100% wound granulation. Comparisons were also made on the mean pain scores during dressing change and the percentage change in wound surface area.
Wounds took an average of 8.4 days in the gauze group and 8.1 days in the foam group (p = 0.698) to achieve full granulation. The percentage change in wound surface area was 5.3 versus 5.5 (P = 0.769) in the gauze and foam groups respectively. The infection rates were comparable between the two groups (28% for gauze and 23.1% for foam, p = 0.697) and there was no significant difference in the median pain scores (gauze = 4.5, foam = 4.8 with p = 0.174). However, outcomes with gauze dressing were influenced significantly by the time to application of NPWT, initial wound surface area and wound infection while with foam dressing outcomes tended to be affected less so by the above factors.
In the use of NPWT for the management of acute traumatic wounds, there is no difference in terms of time to full wound granulation, change in wound surface area, wound infection and pain during dressing change whether gauze or foam is used as the wound dressing material.
几个世纪以来，伤口一直给临床医生带来挑战，这种情况一直持续到21世纪。负压伤口治疗（NPWT）是伤口管理中的最新方法之一。尽管存在一些局限性，但它在发达国家已被广泛采用，默认使用泡沫作为伤口敷料。
确定在NPWT中使用纱布与泡沫作为伤口敷料治疗伴有软组织缺损的急性创伤性伤口时，结果的差异。
前瞻性随机对照干预研究。
肯雅塔国家医院骨科和外科病房。
所有12岁以上患有III级和IV级急性创伤性伤口的患者。
主要观察指标是伤口实现100%肉芽组织生长所需的时间。还比较了换药期间的平均疼痛评分以及伤口表面积的变化百分比。
纱布组伤口平均8.4天实现完全肉芽组织生长，泡沫组为8.1天（p = 0.698）。纱布组和泡沫组伤口表面积的变化百分比分别为5.3和5.5（P = 0.769）。两组的感染率相当（纱布组为28%，泡沫组为23.1%，p = 0.697），中位疼痛评分无显著差异（纱布组 = 4.5，泡沫组 = 4.8，p = 0.174）。然而，纱布敷料的效果受NPWT应用时间、初始伤口表面积和伤口感染的显著影响，而泡沫敷料的效果受上述因素的影响较小。
在使用NPWT治疗急性创伤性伤口时，无论使用纱布还是泡沫作为伤口敷料材料，在伤口完全肉芽组织生长时间、伤口表面积变化、伤口感染及换药时疼痛方面均无差异。
