Scheer H S, Kaiser M, Zingg U
Department of Surgery, Limmattal Hospital, Zurich-Schlieren, Switzerland.
J Wound Care. 2017 Aug 2;26(8):476-481. doi: 10.12968/jowc.2017.26.8.476.
Activated carbon (AC) has been used in wound therapy as an active substance inside dressings. Applying AC directly on a wound is a new concept. The aim of this study was to analyse the outcomes of chronic wounds which were managed with directly applied activated carbon knitted cloth (ACC, Zorflex) in Swiss patients.
A retrospective analysis of the records of all patients with chronic wounds treated with ACC between 1 October 2013 and 31 December 2015 in an outpatient wound clinic. Chronic was defined as a wound being present for >3 weeks. Malignant wounds were excluded. The main outcome was the time to complete closure or readiness for spilt-thickness skin grafting (STSG). Descriptive data, including nutritional status and angiology results were obtained.
There were 36 women and 34 men, median age 68 years old. The median body mass index (BMI) 28.1kg/m and 76% (n=53) of patients had comorbidities. Angiology exam results showed signs of reduced arterial perfusion in 13% (n=9) of patients and malnutrition in 11% (n=8). Of the wounds included 34% (n=24) were on the trunk and 66% (n=46) on the extremities. The median wound size was 6.9cm (range: 0.1-300cm). The wounds on the trunk were larger than wounds on extremities (10 versus 2cm). Overall, median time to wound closure was 51 days. In 94% (n=66) of patients, wounds closed without further intervention and 6% (n=4) underwent STSG. Patients with comorbidities showed longer wound healing times compared with those without. No adverse events such as allergies or skin irritation occurred. Cost analysis, including personnel and material and stratified according known wound closure times, showed ACC (US$ 1252) to be like hydrocolloids (US$ 1128), but substantially lower than white gauze (US$ 3026) and negative pressure wound therapy (NPWT) (US$ 2578).
ACC applied directly on chronic wounds of different aetiology is safe with short closure times. The cost efficiency is high. It combines the positive features of other wound dressings, such as hydrocolloids and NPWT, without their disadvantages. The dressing change of ACC is easy and non-specialised nurses or even patients themselves can be taught to perform it.
活性炭（AC）已作为敷料中的活性物质用于伤口治疗。直接将AC应用于伤口是一个新概念。本研究的目的是分析瑞士患者使用直接应用的活性炭针织布（ACC，Zorflex）治疗慢性伤口的效果。
对2013年10月1日至2015年12月31日在门诊伤口诊所接受ACC治疗的所有慢性伤口患者的记录进行回顾性分析。慢性伤口定义为伤口存在超过3周。排除恶性伤口。主要结局是伤口完全闭合或准备好进行分层皮片移植（STSG）的时间。获取描述性数据，包括营养状况和血管学检查结果。
有36名女性和34名男性，中位年龄68岁。中位体重指数（BMI）为28.1kg/m²，76%（n = 53）的患者有合并症。血管学检查结果显示，13%（n = 9）的患者有动脉灌注减少的迹象，11%（n = 8）的患者有营养不良。纳入的伤口中，34%（n = 24）位于躯干，66%（n = 46）位于四肢。中位伤口大小为6.9cm（范围：0.1 - 300cm）。躯干上的伤口比四肢上的伤口大（分别为10cm和2cm）。总体而言，伤口闭合的中位时间为51天。94%（n = 66）的患者伤口无需进一步干预即可闭合，6%（n = 4）的患者接受了STSG。有合并症的患者伤口愈合时间比无合并症的患者长。未发生过敏或皮肤刺激等不良事件。成本分析包括人员和材料，并根据已知的伤口闭合时间进行分层，结果显示ACC（1252美元）与水胶体（1128美元）相似，但远低于白色纱布（3026美元）和负压伤口治疗（NPWT）（2578美元）。
直接将ACC应用于不同病因的慢性伤口是安全且闭合时间短。成本效益高。它结合了其他伤口敷料如水胶体和NPWT的积极特性，而没有它们的缺点。ACC的换药很容易，非专业护士甚至患者本人都可以学会操作。
