Woodrow Tania, Chant Theresa, Chant Harvey
Specialist Podiatrist Acute Diabetic Foot; Diabetic Foot Clinic, Royal Cornwall Hospital, UK.
Diabetes and Endocrine Research Nurse; Diabetes Research, Cornwall Diabetes Endocrine Centre, Royal Cornwall Hospital, UK.
J Wound Care. 2019 Feb 2;28(2):76-80. doi: 10.12968/jowc.2019.28.2.76.
To evaluate the potential benefit of an intact fish skin graft rich in omega-3 (Kerecis Omega3), in the management of postoperative diabetic foot wounds.
Prospective evaluation in eight patients with diabetes following forefoot surgery. The dressing was applied weekly for a period of six weeks in the diabetic foot clinic. At each visit the wound was photographed and independently measured using ImageJ software to calculate wound area. Secondary outcome measures were pain, infection, odour, discharge and irritation.
The wound area range was 0.94 to 29.55cm². In wounds of less than three months duration, regardless of size, the median percentage wound area reduction was over 84.9% at six weeks (n=6, range: 71.3 to 100%). There were two wounds over three months duration, in these the wound area reduction was <42% at six weeks (n=2, range: 41.2 to 41.1%). No patients developed infection or skin reactions. None reported odour, discharge or itching.
Our initial results demonstrate that the trend towards healing is more marked in wounds less than three months duration. This would suggest that the fish skin graft has potential to decrease time to healing in this patient group when used early on in the healing process, perhaps as a routine adjunct to postoperative diabetic foot wound management.
Postoperative diabetic foot wounds are difficult to heal. In this series, fish skin grafts show promise as an agent to accelerate wound healing. We suggest larger randomised trials to further evaluate its use in acute and chronic wounds.
评估富含ω-3的完整鱼皮移植物(Kerecis Omega3)在糖尿病足术后伤口管理中的潜在益处。
对8例前足手术后的糖尿病患者进行前瞻性评估。在糖尿病足诊所,每周应用该敷料,持续六周。每次就诊时,对伤口进行拍照,并使用ImageJ软件独立测量以计算伤口面积。次要观察指标为疼痛、感染、气味、渗液和刺激情况。
伤口面积范围为0.94至29.55平方厘米。在病程小于三个月的伤口中,无论大小,六周时伤口面积减少的中位数百分比超过84.9%(n = 6,范围:71.3至100%)。有两个伤口病程超过三个月,六周时伤口面积减少小于42%(n = 2,范围:41.2至41.1%)。没有患者发生感染或皮肤反应。无人报告有气味、渗液或瘙痒。
我们的初步结果表明,病程小于三个月的伤口愈合趋势更为明显。这表明鱼皮移植物在愈合过程早期使用时,有可能缩短该患者群体的愈合时间,或许可作为糖尿病足术后伤口管理的常规辅助手段。
糖尿病足术后伤口难以愈合。在本系列研究中,鱼皮移植物显示出有望作为加速伤口愈合的药物。我们建议进行更大规模的随机试验,以进一步评估其在急性和慢性伤口中的应用。