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与标准护理相比,用于慢性伤口管理的生物膜破坏剂的临床评估:一种治疗方法。

Clinical Assessment of a Biofilm-disrupting Agent for the Management of Chronic Wounds Compared With Standard of Care: A Therapeutic Approach.

作者信息

Kim Daniel, Namen Ii William, Moore January, Buchanan Mauricia, Hayes Valerie, Myntti Matthew F, Hakaim Albert

机构信息

Department of Surgery, Division of Vascular Surgery Mayo Clinic, Jacksonville FL.

River City Clinical Research Jacksonville FL.

出版信息

Wounds. 2018 May;30(5):120-130. Epub 2018 Jan 26.

Abstract

OBJECTIVE

The authors study the use of a biofilm-disrupting wound gel designed for wound management to determine if disrupting chronic wound biofilm would be therapeutically efficacious.

MATERIALS AND METHODS

This prospective, randomized, open-label clinical trial was performed from September 2014 through March 2016. Forty-three patients (22 experimental, 21 control) with chronic, recalcitrant wounds were randomized to a 12-week treatment with a biofilm-disrupting wound gel (experimental) or a broad-spectrum antimicrobial ointment (control). The wound healing rate was assessed by measuring wound size reduction and wound closure rates.

RESULTS

Wound size in the experimental group decreased significantly with a 71% reduction in wound area compared with 24% for the control (P < .001). Wound closure was attained in more than half of the patients (14) treated with the experimental product. Fifty-three percent of these patients achieved closure by 12 weeks as opposed to 17% for the control (P < .01). No adverse events related to the experimental product were recorded, but 2 adverse reactions occurred with the control.

CONCLUSIONS

The combination of the experimental product and wound debridement significantly improved wound healing rates by disrupting the biofilm, which protects multispecies bacteria within a chronic wound. Given the significant wound size reduction and closure rates observed in these long-term, nonhealing wounds, as well as the lack of related serious adverse events, the investigators believe the biofilm-disrupting wound gel to be a safe and effective treatment for recalcitrant chronic wounds.

摘要

目的

作者研究一种用于伤口处理的生物膜破坏伤口凝胶的使用情况,以确定破坏慢性伤口生物膜是否具有治疗效果。

材料与方法

这项前瞻性、随机、开放标签的临床试验于2014年9月至2016年3月进行。43例患有慢性顽固性伤口的患者(22例试验组,21例对照组)被随机分为两组,分别接受为期12周的生物膜破坏伤口凝胶(试验组)或广谱抗菌软膏(对照组)治疗。通过测量伤口面积缩小和伤口闭合率来评估伤口愈合率。

结果

试验组伤口大小显著减小,伤口面积减少71%,而对照组为24%(P <.001)。使用试验产品治疗的患者中超过一半(14例)实现了伤口闭合。这些患者中有53%在12周时实现了闭合,而对照组为17%(P <.01)。未记录到与试验产品相关的不良事件,但对照组出现了2例不良反应。

结论

试验产品与伤口清创相结合,通过破坏保护慢性伤口内多种细菌的生物膜,显著提高了伤口愈合率。鉴于在这些长期不愈合伤口中观察到的显著伤口大小缩小和闭合率,以及缺乏相关严重不良事件,研究人员认为生物膜破坏伤口凝胶是治疗顽固性慢性伤口的一种安全有效的方法。

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