Hayes P D, Alzuhir N, Curran G, Loftus I M
Consultant Vascular Surgeon, Department of Vascular Surgery, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, UK.
Clinical Research Fellow, Department of Vascular Surgery, Cambridge University Hospitals NHS Trust, Addenbrooke's Hospital, UK.
J Wound Care. 2017 Nov 2;26(11):652-660. doi: 10.12968/jowc.2017.26.11.652.
Interventions that can heal or reduce diabetic foot ulcer (DFU) size may reduce the incidence of infection and amputation, and reduce associated social and economic costs. Many chronic wounds exhibit a degree of hypoxia and this leads to a reduction in healing processes including cell division and differentiation, angiogenesis, infection prevention, and collagen production. The aim of this pilot study was to assess the effects of a device supplying continuous oxygen ambulatory therapy on healing in chronic DFUs.
Patients with chronic DFUs from two tertiary referral hospitals in the UK received treatment with the device. Data were prospectively obtained on wound size using standardised digital images measured by a clinician blinded to the study. Data on device satisfaction and pain were also obtained.
We recruited 10 patients, with a mean ulcer duration of 43 weeks (median: 43 weeks) before treatment. By week eight, mean ulcer size had decreased by 51% (median: 53%). Seven of the 10 ulcers were in a healing trajectory, one ulcer present for 56 weeks healed completely, a two-year old ulcer was reduced by more than 50%, and a third, present for 88 weeks, was down to 10% of its original size by the end of the eight-week study. There was also a non-significant trend towards reduction in pain and the device was extremely well tolerated.
The ambulatory topical oxygen delivery device showed a significant beneficial effect on wound size. This poses practical advantages over currently existing oxygen-based wound therapies such as hyperbaric oxygen therapy due to its continuous oxygen delivery, ease of use, safety and lower cost. The results of this study warrant further review of the device in comparison to standard wound therapies.
能够治愈糖尿病足溃疡（DFU）或减小其尺寸的干预措施可降低感染和截肢的发生率，并降低相关的社会和经济成本。许多慢性伤口存在一定程度的缺氧，这会导致愈合过程减缓，包括细胞分裂和分化、血管生成、感染预防以及胶原蛋白生成。本初步研究的目的是评估一种提供持续氧气门诊治疗的设备对慢性糖尿病足溃疡愈合的影响。
来自英国两家三级转诊医院的慢性糖尿病足溃疡患者接受了该设备的治疗。通过由对研究不知情的临床医生测量的标准化数字图像前瞻性地获取伤口大小数据。还获取了关于设备满意度和疼痛的数据。
我们招募了10名患者，治疗前溃疡平均持续时间为43周（中位数：43周）。到第8周时，溃疡平均大小减少了51%（中位数：53%）。10个溃疡中有7个处于愈合进程，一个存在56周的溃疡完全愈合，一个两年的溃疡缩小了50%以上，第三个存在88周的溃疡在为期8周的研究结束时缩小至其原始大小的10%。疼痛也有不显著的减轻趋势，并且该设备耐受性极佳。
门诊局部给氧设备对伤口大小显示出显著的有益效果。与目前现有的基于氧气的伤口治疗方法（如高压氧治疗）相比，由于其持续供氧、使用方便、安全且成本较低，具有实际优势。本研究结果值得将该设备与标准伤口治疗方法进行进一步比较评估。
