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含硅酮粘合剂的银泡沫敷料对轻度感染糖尿病足溃疡的临床及抗菌疗效

Clinical and Antimicrobial Efficacy of a Silver Foam Dressing With Silicone Adhesive in Diabetic Foot Ulcers With Mild Infection.

作者信息

Lázaro-Martínez José Luis, Álvaro-Afonso Francisco Javier, Sevillano-Fernández David, Molines-Barroso Raúl Juan, García-Álvarez Yolanda, García-Morales Esther

机构信息

Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.

出版信息

Int J Low Extrem Wounds. 2019 Sep;18(3):269-278. doi: 10.1177/1534734619866610. Epub 2019 Aug 5.

Abstract

The use of an antimicrobial dressing instead of a non-antimicrobial dressing may increase the number of diabetic foot ulcers healed over a medium-term follow-up period. The study aim was to evaluate the clinical and microbiological efficacy of a silver foam dressing in the management of diabetic foot ulcers. We conducted a single-center, prospective, open, noncontrolled study involving 21 outpatients with diabetic foot ulcers with mild infection. All patients received standard of care for their wounds and a silver foam dressing with silicone adhesive was applied twice per week for wound management during a 6-week treatment period. Soft tissue punch biopsies were taken every second week for qualitative and quantitative microbiological analysis. Wounds were assessed at patient admission, and wound bed tissue was evaluated for presence, quality, and consistency of granulation tissue. Clinical evaluation revealed improvements in wound conditions as a result of treatment with the silver dressing. Wollina wound scores improved significantly, from a mean score of 3.9 ± 1.6 points at inclusion to 6.1 ± 1.3 points at the end of the study (n = 19, < .001). Treatment with the silver dressing resulted in significant decreases in the bioburden of classically considered diabetic foot ulcer pathogenic organisms such as , including methicillin-resistant species, , and other nonfermenting gram-negative bacilli. Findings revealed that the use of silver foam dressing significantly reduced the pathogenic bacterial load and markedly improved the clinical outcome in patients with diabetic foot ulcer with mild infection over a 6-week treatment period.

摘要

在中期随访期内,使用抗菌敷料而非非抗菌敷料可能会增加愈合的糖尿病足溃疡数量。本研究的目的是评估一种银泡沫敷料在糖尿病足溃疡治疗中的临床和微生物学疗效。我们进行了一项单中心、前瞻性、开放性、非对照研究,纳入了21例患有轻度感染的糖尿病足溃疡门诊患者。所有患者均接受伤口的标准护理,并在为期6周的治疗期间每周两次应用带有硅酮粘合剂的银泡沫敷料进行伤口处理。每隔一周进行一次软组织穿刺活检,以进行定性和定量微生物学分析。在患者入院时对伤口进行评估,并对伤口床组织进行评估,以确定肉芽组织的存在、质量和稠度。临床评估显示,使用银敷料治疗后伤口状况有所改善。Wollina伤口评分显著提高,从纳入时的平均3.9±1.6分提高到研究结束时的6.1±1.3分(n = 19,P <.001)。使用银敷料治疗使经典认为的糖尿病足溃疡致病微生物(如耐甲氧西林金黄色葡萄球菌、大肠杆菌和其他非发酵革兰氏阴性杆菌)的生物负荷显著降低。研究结果显示,在为期6周的治疗期内,使用银泡沫敷料可显著降低患有轻度感染的糖尿病足溃疡患者的病原菌负荷,并显著改善临床结局。

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