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J Wound Care. 2020 Jul 1;29(Sup7):S6-S15. doi: 10.12968/jowc.2020.29.Sup7.S6.
Wound infections result in considerable morbidity, mortality and healthcare costs. Antibiotic resistance has complicated wound healing, and new, non-antibiotic-based treatment methods are being developed.
To evaluate evidence on the safety, efficacy and real-world effectiveness of electroceutical devices (ECDs) that provide continuous electrical stimulation to wounds.
A systematic search was conducted to identify primary studies published between 2009 and 2019 that described therapeutic wound treatment using portable ECDs. Studies were included if the ECD delivered continuous electrical current directly to the wound area for the duration of treatment.
Of 171 citations identified in the search, 13 articles met the inclusion criteria and were analysed. Nine studies evaluated dressings embedded with zinc and silver particles that generated electricity electrochemically, and four evaluated electrode-based units with external batteries. ECDs were effective in healing complex, hard-to-heal wounds that had not responded to other treatments. Four studies showed that ECDs led to complete closure of wounds without complications, and in some cases healed wounds faster than standard of care (SOC). One study found that ECDs resulted in higher ratings by both patients and surgeons than SOC for the progression of wound healing and scar appearance. Additionally, three studies found ECD treatment was less expensive than SOC, due to patients requiring fewer dressing changes or nurse visits.
ECDs appeared to be a safe, effective and cost-effective method for treating severe, complex and challenging wounds, including hard-to-heal wounds, surgical incisions and skin graft donor sites.
伤口感染会导致相当大的发病率、死亡率和医疗保健成本。抗生素耐药性使伤口愈合变得复杂,并且正在开发新的、非抗生素的治疗方法。
评估提供持续电刺激给伤口的电疗设备(ECDs)的安全性、疗效和实际效果的证据。
系统搜索了 2009 年至 2019 年间发表的描述使用便携式 ECD 进行治疗性伤口处理的原始研究。如果 ECD 在治疗期间直接将连续电流输送到伤口区域,则将研究纳入。
在搜索中确定了 171 个引用,其中 13 篇文章符合纳入标准并进行了分析。有 9 项研究评估了嵌入锌和银颗粒的敷料,这些颗粒通过电化学产生电流,还有 4 项研究评估了带有外部电池的基于电极的装置。ECDs 对复杂、难以愈合的伤口有效,这些伤口对其他治疗方法没有反应。四项研究表明,ECDs 导致伤口完全闭合,没有并发症,并且在某些情况下比标准护理(SOC)更快地愈合伤口。一项研究发现,ECDs 在伤口愈合和疤痕外观方面的进展方面,患者和外科医生的评分都高于 SOC。此外,三项研究发现,由于患者需要更换敷料或接受护士就诊的次数较少,ECDs 治疗比 SOC 更便宜。
ECDs 似乎是一种安全、有效且具有成本效益的治疗严重、复杂和具有挑战性的伤口的方法,包括难以愈合的伤口、手术切口和皮肤移植物供体部位。