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[Clinical efficacy of negative-pressure wound therapy combined with porcine acellular dermal matrix for repairing deep burn wounds in limbs].

作者信息

Liu Wei, Li Feng, Chen Xin, Pan Qing

机构信息

Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2016 Jun;32(6):356-62. doi: 10.3760/cma.j.issn.1009-2587.2016.06.011.


DOI:10.3760/cma.j.issn.1009-2587.2016.06.011
PMID:27321490
Abstract

OBJECTIVE: To observe the clinical efficacy of negative pressure wound therapy (NPWT) in combination with porcine acellular dermal matrix (ADM) dressing for repairing deep burn wounds in limbs of patients with non-surgical treatment. METHODS: Thirty-two patients with deep partial-thickness burn to full-thickness burn on the limbs admitted to our ward from June 2012 to December 2015, conforming to the inclusion criteria, were divided into group NPWT (n=10, treated with interval negative pressure drainage at -16.6 kPa), group ADM (n=7, treated with porcine ADM dressing), and group NPWT+ ADM (n=15, treated with interval negative pressure drainage and porcine ADM dressing as above) according to the random number table and patient's consent. After being treated for 21 d, residual wounds were cured by routine dressing change using sulfadiazine silver. On post treatment day (PTD) 7, 14, and 21, wound gross observation was conducted, wound drainage fluid volume was recorded, and wound healing rate was calculated. Wound secretion was collected for bacterial culture before treatment and on PTD 21, and bacterial clearance effect was recorded. The wound healing time was also recorded. Measurement data were processed with analysis of variance for repeated measurement, one-way analysis of variance, and LSD test. Eenumeration data were processed with chi-square test or Fisher's exact test. RESULTS: (1) On PTD 7, the wounds of patients in group NPWT and group NPWT+ ADM were significantly shrinked as compared with those before treatment. Skin paddle scattered on the wounds of patients in group NPWT+ ADM on PTD 7. The wounds of patients in group ADM were slightly shrinked on PTD 7 as compared with those before treatment. On PTD 14, the wounds of patients in group NPWT were slightly shrinked as compared with those on PTD 7, while those in group NPWT+ ADM were significantly shrinked as compared with those on PTD 7. Skin paddle on the wounds of patients in group NPWT+ ADM on PTD 14 were increased and fused. The wounds of patients in group ADM were significantly shrinked on PTD 14 as compared with those on PTD 7. On PTD 21, partial wounds of patients in group NPWT were healed, while the wounds of patients in group ADM were slightly shrinked in comparison with those on PTD 14 and most of wounds were not healed. Most of wounds of patients in group NPWT+ ADM were healed. (2) On PTD 7, the wound drainage fluid volumes of patients in group NPWT and group NPWT+ ADM were obviously more than the wound drainage fluid volume of patients in group ADM (with P values below 0.01). On PTD 14, the wound drainage fluid volume of patients in group NPWT was significantly more than that in group ADM (P<0.01); while that between group ADM and group NPWT+ ADM was close (P>0.05). On PTD 21, the wound drainage fluid volume of patients in group NPWT and group NPWT+ ADM was significantly less than that in group ADM (with P values below 0.01). From PTD 7 to 21, the wound drainage fluid volumes of patients in group NPWT+ ADM were significantly reduced as compared with those in group NPWT (with P values below 0.01). (3) On PTD 7, the wound healing rates of patients in group ADM and group NPWT+ ADM were significantly lower than the wound healing rate of patients in group NPWT (P<0.05 or P<0.01), and the wound healing rate of patients in group NPWT+ ADM was significantly higher than that in group ADM (P<0.01). On PTD 14 and 21, the wound healing rates of patients in group NPWT+ ADM were significantly higher than those in group NPWT and group ADM (with P values below 0.01), and the wound healing rates of patients in group NPWT were significantly higher than those in group ADM (with P values below 0.01). (4) Before treatment, the bacteria were respectively detected in 18, 11, and 23 wounds of patients in group NPWT, group ADM, and group NPWT+ ADM. On PTD 21, the bacteria were respectively detected in 2, 8, and 2 wounds of patients in group NPWT, group ADM, and group NPWT+ ADM. The bacterial clearance of wounds of patients in group NPWT and group NPWT+ ADM was significantly better than that of patients in group ADM (with P values below 0.01). The bacterial clearance of wounds of patients in group NPWT+ ADM was close to that in group NPWT (P=1.00). (5) The wound healing time of patients in group NPWT+ ADM was (18.7±1.2) d, which was significantly shorter than that in group NPWT [(23.9±1.5) d] and group ADM [(28.4±1.8) d], with P values below 0.01. The wound healing time of patients in group NPWT was significantly shorter than that in group ADM (P<0.01). CONCLUSIONS: NPWT combined with porcine ADM dressing can effectively remove wound bacteria, reduce wound exudation, and promote wound healing in repairing deep partial-thickness burn wounds and full-thickness burn wounds. Its clinical effect is better than NPWT or porcine ADM dressing alone, and this method may be suitable for patients with non-surgical treatment.

摘要

相似文献

[1]
[Clinical efficacy of negative-pressure wound therapy combined with porcine acellular dermal matrix for repairing deep burn wounds in limbs].

Zhonghua Shao Shang Za Zhi. 2016-6

[2]
[Influence of different inner dressings in negative-pressure wound therapy on escharectomy wound of full-thickness burn rabbits].

Zhonghua Shao Shang Za Zhi. 2017-7-20

[3]
[Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on chronic wounds in diabetic patients].

Zhonghua Shao Shang Za Zhi. 2014-4

[4]
[Influence of covering of auto-crosslinked sodium hyaluronate gel in combination with xenogenic acellular dermal matrix on healing of full-thickness skin defect wound in pig].

Zhonghua Shao Shang Za Zhi. 2016-9-20

[5]
[Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2024-4-20

[6]
[Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on wounds of pa- tients with chronic venous leg ulcers].

Zhonghua Shao Shang Za Zhi. 2015-4

[7]
[Preliminary effect observation on the application of micro-negative pressure in children with small-area deep partial-thickness burn].

Zhonghua Shao Shang Za Zhi. 2019-10-20

[8]
[Effects of porcine acellular dermal matrix combined with human epidermal stem cells on wound healing of full-thickness skin defect in nude mice].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-1-20

[9]
[Effects of minimally invasive tangential excision in treating deep partial-thickness burn wounds on trunk and limbs in pediatric patients in the early stage post burn].

Zhonghua Shao Shang Za Zhi. 2018-10-20

[10]
[Clinical efficacy and influencing factors of different modes of continuous negative pressure wound therapy on venous ulcer wounds of lower limbs].

Zhonghua Shao Shang Za Zhi. 2020-12-20

引用本文的文献

[1]
Reconstruction of full thickness wounds using glyaderm in a single-staged procedure.

Cell Tissue Bank. 2021-6

[2]
Negative pressure wound therapy for burn patients: A meta-analysis and systematic review.

Int Wound J. 2021-2

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