Huett Elizabeth, Bartley Whitney, Morris Darla, Reasbeck Della, McKitrick-Bandy Beth, Yates Charlotte
Department of Physical Therapy, Arkansas Children's Hospital, Little Rock, Arkansas.
Department of Physical Therapy, University of Central Arkansas, Conway, Arkansas.
Pediatr Dermatol. 2017 May;34(3):277-281. doi: 10.1111/pde.13118.
BACKGROUND/OBJECTIVES: The use of collagenase for enzymatic wound debridement has been studied extensively and has been established as the standard of care for nonhealing and necrotic wounds in individuals for whom surgical intervention is not an option. Collagenase has been shown to be effective in adults but has been studied in a limited capacity in infants and neonates. The purpose of this study was to investigate the use of collagenase in the neonatal intensive care unit (NICU).
Retrospective chart review of infants and neonates admitted to the NICU at Arkansas Children's Hospital with nonhealing wounds for which collagenase was used for wound healing over a 1-year time period. Six wounds were identified: five surgical wound dehiscence and one intravenous infiltrate.
Before the use of collagenase, five of the six wounds had been treated with an alternative dressing. Once collagenase was initiated, three of these wounds reached complete granulation and closure in less time than in the episode of prior therapy. The number of days to reach 100% granulation once treated with collagenase was 5 to 18 days (mean 12.2 days). Surgical intervention for the debridement and closure of these wounds was not required, providing cost savings to the patient. Daily wound care was completed with negligible pain recordings.
The use of collagenase for enzymatic debridement can be beneficial, safe, and effective for the treatment of nonhealing and necrotic wounds in infants and neonates.
背景/目的：胶原酶用于酶解清创术已得到广泛研究，并已成为手术干预不可行的个体中不愈合和坏死伤口护理的标准方法。胶原酶已被证明在成人中有效，但在婴儿和新生儿中的研究有限。本研究的目的是调查胶原酶在新生儿重症监护病房（NICU）中的应用。
回顾性查阅阿肯色儿童医院NICU收治的婴儿和新生儿病历，这些患儿有不愈合伤口，在1年时间内使用胶原酶促进伤口愈合。共识别出6处伤口：5处手术伤口裂开和1处静脉渗漏。
在使用胶原酶之前，6处伤口中有5处采用了其他敷料治疗。开始使用胶原酶后，其中3处伤口在比先前治疗阶段更短的时间内实现了完全肉芽形成和愈合。使用胶原酶后达到100%肉芽形成的天数为5至18天（平均12.2天）。无需对这些伤口进行清创和闭合的手术干预，为患者节省了费用。每日伤口护理完成时疼痛记录可忽略不计。
胶原酶用于酶解清创术对治疗婴儿和新生儿的不愈合和坏死伤口可能有益、安全且有效。
