Chadwick P, McCardle J
Salford Royal Hospital NHS Foundation Trust, UK.
Royal Infirmary of Edinburgh, UK.
J Wound Care. 2016 May;25(5):290-300. doi: 10.12968/jowc.2016.25.5.290.
To evaluate the performance and safety of Exufiber, a gelling fibre wound dressing incorporating Hydrolock technology, in the management of highly exuding diabetic foot ulcers (DFUs).
The study was conducted over a 12 week period involving a total of 21 patients with DFUs. A number of parameters were measured to monitor the change in condition of the peri-wound skin from baseline assessments. The evaluation of dressing-related pain was measured using a 100mm visual analogue scale (VAS). Wound status (measured by changes in wound size and healing phase) was recorded. Clinician/patient opinions of the test product and technical performance (measured by the presence of dressing residue following removal and handling of wound exudate) were also recorded.
The number of patients with healthy/intact peri-wound skin increased from baseline to the final visit. There was also a steady decrease in wound exudate volume throughout the study. Pain levels were very low throughout the investigation period, bearing in mind issues with neuropathy. A gradual decline in all wound size parameters from baseline to the final visit was noted; there was a statistically significant reduction in both wound area (cm(2)), p=0.0094, and wound volume (cc), p=0.0056, from baseline to the final visit. Throughout the study, a small decline in the mean percentage of granulation tissue within the wound paralleled a gradual increase in the mean percentage of epithelialisation tissue, while the percentage of non-viable tissue remained very low. The primary endpoints of product performance and safety were measured by the changes from baseline in the condition of the peri-wound skin. Results showed that the number of patients with healthy/intact peri-wound skin increased from baseline to the final visit, increasing from 6 patients (28.6%) at baseline to 14 patients (66.7%) at the final visit. There were no occurrences of product degradation on the skin and no reported adverse events (AE)/adverse device effects (ADE) during the course of the study that were judged to be related to the investigational product.
This study has demonstrated the capacity for the test dressing to minimise damage to the peri-wound skin and dressing-associated pain. Despite the majority of wounds remaining unhealed at the final visit, improvements were noted in terms of tissue type and a significant reduction in wound area and volume. The technical performance of the dressing was demonstrated by an ability to absorb and retain exudate. Product safety was also demonstrated by an increase in the number of patients with healthy/intact peri-wound skin and the lack of identified product-related AE/ADEs.
The study was supported by an unrestricted educational grant from Mölnlycke Health Care.
评估采用Hydrolock技术的凝胶纤维伤口敷料Exufiber在治疗高度渗出性糖尿病足溃疡(DFU)中的性能及安全性。
本研究为期12周,共纳入21例DFU患者。测量了多个参数,以监测伤口周围皮肤状况相对于基线评估的变化。使用100毫米视觉模拟量表(VAS)评估与敷料相关的疼痛。记录伤口状况(通过伤口大小和愈合阶段的变化来衡量)。还记录了临床医生/患者对测试产品的意见以及技术性能(通过去除敷料和处理伤口渗出物后是否存在敷料残留来衡量)。
从基线到最后一次随访,伤口周围皮肤健康/完整的患者数量有所增加。在整个研究过程中,伤口渗出液量也稳步减少。考虑到神经病变问题,在整个研究期间疼痛水平都非常低。从基线到最后一次随访,所有伤口大小参数均逐渐下降;从基线到最后一次随访,伤口面积(平方厘米)和伤口体积(立方厘米)均有统计学显著减少,分别为p = 0.0094和p = 0.0056。在整个研究过程中,伤口内肉芽组织平均百分比略有下降,同时上皮化组织平均百分比逐渐增加,而非存活组织的百分比仍然很低。产品性能和安全性的主要终点通过伤口周围皮肤状况相对于基线的变化来衡量。结果显示,伤口周围皮肤健康/完整的患者数量从基线到最后一次随访有所增加,从基线时的6例患者(28.6%)增加到最后一次随访时的14例患者(66.7%)。在研究过程中,皮肤上未出现产品降解情况,也未报告被判定与研究产品相关 的不良事件(AE)/不良器械效应(ADE)。
本研究证明了测试敷料有能力将对伤口周围皮肤的损伤以及与敷料相关的疼痛降至最低。尽管在最后一次随访时大多数伤口仍未愈合,但在组织类型方面有改善,且伤口面积和体积显著减小。敷料的技术性能体现在其吸收和保留渗出液的能力上。伤口周围皮肤健康/完整的患者数量增加以及未发现与产品相关的AE/ADE,也证明了产品的安全性。
本研究由莫林医疗保健公司提供的无限制教育资助支持。