Bongiovanni Cheryl M
Wound Clinics and Vascular Laboratories, Lake Health District, Lake District Hospital, 700 South J Street, Lakeview, OR 97630, USA; Lake Wound Clinic - Klamath Falls, LLC, 2301 B Mountain View Boulevard, Klamath Falls, OR 97601, USA.
J Am Coll Clin Wound Spec. 2016 Jan 21;6(3):32-7. doi: 10.1016/j.jccw.2016.01.001. eCollection 2014 Dec.
In order to assess the impact of comorbidities and identify factors that accelerate the healing rate of venous leg ulcers we performed an extensive, retrospective analysis of our experience in a diverse population. From June, 2006 to June, 2014, 897 patients with 1249 venous leg ulcers were treated at Lake Wound Clinics. Treatment protocols utilized the standard regimen of wound cleaning, debridement and compression bandaging. Wound cleaning, autolytic debridement, packing and dressing of venous leg ulcers utilized aqueous solutions of hypochlorous acid (HCA) rather than the standard normal saline. This protocol caused all ulcers to close completely. Comorbidities that delayed healing included uncontrolled or poorly controlled diabetes mellitus, advanced peripheral artery occlusive disease (PAD), active smoking, use of steroid medications and/or street drugs, large initial ulcer size and significant depth. Other factors, including advanced age, recurrent venous ulceration, stasis dermatitis, lipodermatosclerosis, morbid obesity and infection with one or more multidrug resistant organisms did not delay closure. From this experience we conclude that venous leg ulcer care protocols that clean, debride, pack and dress with hypochlorous acid solutions can reduce the effects of some comorbidities while accelerating healing times. Additional benefits are described.
为了评估合并症的影响并确定加速下肢静脉溃疡愈合速度的因素,我们对不同人群的治疗经验进行了广泛的回顾性分析。2006年6月至2014年6月期间,湖伤诊所共治疗了897例患有1249处下肢静脉溃疡的患者。治疗方案采用伤口清洁、清创和加压包扎的标准疗法。下肢静脉溃疡的伤口清洁、自溶性清创、填充和包扎使用的是次氯酸(HCA)水溶液,而非标准的生理盐水。该方案使所有溃疡完全愈合。延迟愈合的合并症包括未得到控制或控制不佳的糖尿病、晚期外周动脉闭塞性疾病(PAD)、主动吸烟、使用类固醇药物和/或毒品、初始溃疡面积大及深度深。其他因素,包括高龄、复发性静脉溃疡、淤积性皮炎、脂肪硬化性皮病、病态肥胖以及感染一种或多种多重耐药菌,并未延迟溃疡愈合。基于这一经验,我们得出结论,使用次氯酸溶液进行清洁、清创、填充和包扎的下肢静脉溃疡护理方案,在加速愈合时间的同时,可减轻某些合并症的影响。文中还描述了其他益处。