Hodgson H, Davidson D, Duncan A, Guthrie J, Henderson E, MacDiarmid M, McGown K, Pollard V, Potter R, Rodgers A, Wilson A, Horner J, Doran M, Simm S, Taylor R, Rogers A, Rippon M G, Colgrave M
Lead Investigator, Lead Nurse Tissue Viability, Tissue Viability Acute and Partnerships, Glasgow.
Vascular Nurse Specialist, Inverclyde Royal Hospital, Greenock.
J Wound Care. 2017 Nov 2;26(11):642-650. doi: 10.12968/jowc.2017.26.11.642.
Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed.
This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing.
We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46).
HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.
我们的目的是评估水响应性伤口敷料（HRWD）在清创和伤口床准备方面对各种急慢性伤口的有效性，这些伤口存在需要清除的失活组织，以便伤口能够愈合。
这是一项对需要清创作为常规治疗方案一部分的急慢性伤口的非对照评估。临床医生记录伤口变化，包括对失活组织和伤口床准备情况的主观评估水平、疼痛情况、伤口状态（如伤口大小）和伤口周围皮肤状况。还从临床医生和患者那里收集数据，以提供有关敷料临床性能的信息。
我们招募了100名患有各种伤口类型的患者参与研究。超过90%的临床医生报告称，在慢性和急性伤口中均有失活组织被清除，从而促进了愈合反应。具体而言，在评估期间，失活组织（坏死组织和腐肉）水平从85.5%降至26.3%，同时伤口床肉芽组织从12.0%增加到33.7%。相应地，伤口面积减少了40%，因此使用HRWD治疗后可见具有临床意义的愈合反应。同样值得注意的是，该患者群体中包括相当比例的慢性伤口（51.4%），这些伤口在纳入研究前不到4周内没有伤口进展的迹象。在这些慢性伤口中，93%在使用HRWD治疗后出现了伤口进展。尽管换药前后报告的疼痛水平较低，但48%的患者总体伤口疼痛有所改善（减轻）。伤口周围皮肤状况有改善趋势，并且在大多数情况下，HRWD的液体管理能力被报告为良好至优秀。在评估期间，伤口感染减少了至少60%。一项简单的成本效益分析表明，使用HRWD（6.33英镑）比当前标准的四步清创流程（8.05英镑）、幼虫疗法（306.39英镑）和机械垫清创法（11.46英镑）节省了大量费用。
HRWD耐受性良好，被证明是一种有效的清创工具，能在各种伤口类型中提供快速、有效且无痛的清创。
