Oropallo Alisha R
Department of Surgery, Northwell Health, Lake Success, N.Y.
Department of Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, N.Y.
Plast Reconstr Surg Glob Open. 2019 Jan 15;7(1):e2047. doi: 10.1097/GOX.0000000000002047. eCollection 2019 Jan.
Chronic wounds represent a significant financial burden to the healthcare system and a quality-of-life burden to patients. Many chronic wounds have elevated bioburden in the form of biofilm, which has been associated with delayed wound healing. This study examined the use of a native type I collagen matrix with the antimicrobial polyhexamethylene biguanide (PCMP) in the management of bioburden and treatment of chronic, nonhealing wounds over 12 weeks.
A prospective case series of PCMP enrolled adults ≥18 years old with a nonhealing wound. At week 0, the wound was prepared by sharp or mechanical debridement. Patients received standard wound care plus PCMP applications at week 0 and then weekly up to week 12 at the investigator's discretion. Dressings were applied over PCMP to fix it in place. At each visit, wounds were assessed for the extent of healing and signs of wound infection.
Of the 41 wounds studied, 44% were pressure ulcers, 22% were surgical wounds, 12% were venous ulcers, 10% were diabetic ulcers, and 12% were another type. The median (interquartile range) baseline wound area was 7.2 (14.9) cm, and the mean wound duration was 103 weeks. Of the 41 wounds, 73% demonstrated a reduction in wound area at 12 weeks, and 37% achieved complete wound closure, with a mean time of 6.7 weeks to complete closure.
PCMP treatment appeared to positively impact the course of wound healing in a variety of complex, chronic wounds that were unresponsive to prior treatment.
慢性伤口给医疗系统带来了巨大的经济负担，也给患者的生活质量造成了负担。许多慢性伤口以生物膜的形式存在生物负荷升高的情况，这与伤口愈合延迟有关。本研究在12周内检查了天然I型胶原蛋白基质与抗菌剂聚六亚甲基双胍（PCMP）在管理生物负荷和治疗慢性不愈合伤口方面的应用。
一项前瞻性病例系列研究，纳入了年龄≥18岁的患有不愈合伤口的成年人。在第0周，通过锐性或机械清创术对伤口进行处理。患者在第0周接受标准伤口护理并应用PCMP，然后由研究者自行决定每周应用一次，直至第12周。在PCMP上覆盖敷料以固定其位置。每次就诊时，评估伤口的愈合程度和伤口感染迹象。
在研究的41处伤口中，44%为压疮，22%为手术伤口，12%为静脉溃疡，10%为糖尿病溃疡，12%为其他类型。基线伤口面积的中位数（四分位间距）为7.2（14.9）平方厘米，平均伤口持续时间为103周。在41处伤口中，73%在12周时伤口面积减小，37%实现了伤口完全闭合，完全闭合的平均时间为6.7周。
PCMP治疗似乎对多种先前治疗无反应的复杂慢性伤口的愈合过程产生了积极影响。
