The Ottawa Hospital: Limb Preservation Program, Ottawa, Canada.
Faculty of Health Rehabilitation Sciences, Western University, London, Canada.
Int Wound J. 2018 Jun;15(3):460-472. doi: 10.1111/iwj.12887. Epub 2018 Jan 15.
The aim of this study was to compare changes in wound size and appearance and health complication rates in patients with vasculopathy and lower-extremity wounds treated with or without low-frequency contact ultrasound debridement (LFCUD) This study was a randomised controlled trial. The study was conducted in a vascular surgery service, including outpatient wound clinic and inpatient ward, in a tertiary care academic centre. In total, 70 patients with vasculopathy and lower-extremity wounds of mixed aetiology were enrolled in the trial; 68 completed the study. Patients were randomised to receive LFCUD plus usual care (n = 33) or usual care (n = 37) at 4 weekly visits, and were followed thereafter for up to 12 wk. The main outcome measures included closed wounds, change in wound surface area (WSA), and wound appearance by the revised Photographic Wound Assessment Tool (revPWAT). After 4 weekly LFCUD treatments, patients in the LFCUD group had significantly better wound appearance (total revPWAT score) compared with the control group treated only with usual care (P = <0.05). LFCUD-treated wounds also had a significant reduction in WSA over 4 wk that was not found in the UC group. LFCUD treatment was also associated with a greater number of healed wounds, odds ratio 5.00 (95% CI 1.24-20.25), and fewer instances of wound deterioration. Weekly LFCUD applications to patients with significant vasculopathy resulted in superior healing outcomes when compared with current usual wound care practice.
本研究旨在比较血管病变和下肢伤口患者在接受或不接受低频接触超声清创术(LFCUD)治疗后的伤口大小和外观变化以及健康并发症发生率。本研究为一项随机对照试验。该研究在一家三级保健学术中心的血管外科服务机构进行,包括门诊伤口诊所和住院病房。共有 70 名患有血管病变和下肢混合病因伤口的患者参与了试验;68 名患者完成了研究。患者被随机分配接受 LFCUD 加常规护理(n = 33)或仅接受常规护理(n = 37),每周 4 次,此后最多随访 12 周。主要结局指标包括闭合伤口、伤口表面积(WSA)变化以及使用改良摄影伤口评估工具(revPWAT)评估的伤口外观。在接受 4 周的 LFCUD 治疗后,与仅接受常规护理治疗的对照组相比,LFCUD 组患者的伤口外观(总 revPWAT 评分)显著改善(P < 0.05)。LFCUD 治疗组的 WSA 在 4 周内也显著减少,而 UC 组则没有发现这种情况。LFCUD 治疗还与更多的愈合伤口相关,优势比为 5.00(95%CI 1.24-20.25),并且恶化的伤口更少。与当前的常规伤口护理实践相比,每周对有明显血管病变的患者进行 LFCUD 应用可获得更好的愈合结果。