Lullove Eric J
West Boca Center for Wound Healing, Boca Raton, FL.
Wounds. 2017 Apr;29(4):107-114.
Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times.
The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers).
Patients were treated twice weekly in an outpatient clinic for the first 4 weeks and weekly thereafter until closure.
Average body mass index (BMI) for the study population was 28.3, and the average patient age was 75.9 years. Mean percent wound surface area reduction at 4, 8, and 12 weeks was 38.5%, 73.3%, and 91.3%, respectively. Average time to closure for all wounds was 10.6 weeks (range, 5-24 weeks). All wounds were 100% reepithelialized by week 20 except 1 DFU that reepithelialized at week 24. The average cost of care for a single wound episode (from presentation to closure) was $2749.49.
Results of this analysis showed that the healing of chronic wounds in this series could be achieved at a reasonable cost with regular debridement and a collagen matrix dressing regimen, even in patients of advanced age and above average BMI as well as in wounds that did not achieve > 40% wound surface area reduction at 4 weeks.
能减少广谱金属蛋白酶并具备细胞外基质固有特性的敷料,可能有助于改善伤口愈合效果并缩短治疗时间。
作者进行了一项回顾性病例系列分析,以确定使用羊源性胶原蛋白细胞外基质敷料和龙胆紫/亚甲蓝聚氨酯抗菌泡沫敷料定期清创治疗53例患者的53处慢性下肢伤口(糖尿病足溃疡[DFUs]、下肢静脉溃疡和足跟压疮)的临床效果。
患者在门诊每周治疗两次,前4周如此,之后每周治疗一次,直至伤口愈合。
研究人群的平均体重指数(BMI)为28.3,患者平均年龄为75.9岁。在4周、8周和12周时伤口表面积平均减少百分比分别为38.5%、73.3%和91.3%。所有伤口的平均愈合时间为10.6周(范围为5 - 24周)。除1例糖尿病足溃疡在第24周重新上皮化外,所有伤口在第20周时均100%重新上皮化。单个伤口治疗过程(从就诊到愈合)的平均护理费用为2749.49美元。
该分析结果表明,即使是高龄且BMI高于平均水平的患者,以及在4周时伤口表面积减少未超过40%的伤口,通过定期清创和胶原蛋白基质敷料方案,本系列慢性伤口仍能以合理成本实现愈合。