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富含血小板血浆治疗慢性静脉性下肢溃疡的临床和微生物学结局:一项随机对照试验。

Clinical and Microbiological Outcomes Associated With Use of Platelet-Rich Plasma in Chronic Venous Leg Uclers: A Randomized Controlled Trial.

机构信息

Bruna Maiara Ferreira Barreto Pires, PhD, RN, Universidade Federal Fluminense, Niterói, Brazil.

Beatriz Guitton Renaud Baptista de Oliveira, PhD, Universidade Federal Fluminense, Niterói, Brazil.

出版信息

J Wound Ostomy Continence Nurs. 2021;48(4):292-299. doi: 10.1097/WON.0000000000000774.

Abstract

PURPOSE

To evaluate the susceptibility profiles of Staphylococcus aureus and Pseudomonas aeruginosa strains identified in chronic venous ulcers treated with platelet-rich plasma (PRP) and petrolatum gauze or petrolatum gauze alone and to quantitatively evaluate the bacterial load and biofilm-forming capacities of the detected S. aureus and P. aeruginosa strains.

DESIGN

Randomized controlled trial.

SUBJECTS AND SETTING

The convenience sample included 36 participants; 18 were allocated to the PRP combined with the petrolatum gauze group, and 18 were allocated to the control group, which was treated with petrolatum gauze alone.

METHODS

Thirty-six patients presenting with chronic venous ulcers were consecutively randomized to the PRP group (n = 18) or the petrolatum gauze control group (n = 18). We followed participants for 3 months during treatment and collected swab cultures from their wounds during weeks 1, 6, and 12 or until the wounds healed. The samples were analyzed using mass spectrometry. Antimicrobial susceptibility tests were performed using disk diffusion.

RESULTS

P. aeruginosa was identified in 39 (39%) of 100 samples, and S. aureus was detected in only 10 (10%) samples collected over the study period. At the end of the 12-week treatment period, the wound infections reduced in both the PRP (P = .0078) and control groups (P = .01). The microorganisms were susceptible to most of the tested antimicrobials. The PRP did not increase the bacterial load in the wounds. All S. aureus strains identified showed biofilm-forming capacities and were classified as weak biofilm producers. All P. aeruginosa strains produced biofilm, with 17 strains being classified as weak, 14 as moderate, and 8 as strong biofilm producers.

CONCLUSIONS

The PRP plus petrolatum gauze did not increase bacteriological growth or the microbial load in chronic venous ulcers compared with petrolatum gauze alone and could be a considered as an advanced treatment option for these types of chronic wounds.

摘要

目的

评估富含血小板血浆(PRP)联合凡士林纱布与单独使用凡士林纱布治疗慢性静脉溃疡时分离的金黄色葡萄球菌和铜绿假单胞菌的药敏谱,并定量评估所检测的金黄色葡萄球菌和铜绿假单胞菌的细菌载量和生物膜形成能力。

设计

随机对照试验。

受试者和设置

方便样本包括 36 名参与者;18 名参与者被分配到 PRP 联合凡士林纱布组,18 名参与者被分配到单独使用凡士林纱布的对照组。

方法

连续将 36 例患有慢性静脉溃疡的患者随机分为 PRP 组(n = 18)或凡士林纱布对照组(n = 18)。我们在治疗期间对参与者进行了 3 个月的随访,并在第 1、6 和 12 周或直至伤口愈合时从他们的伤口采集拭子培养物。使用质谱分析法分析样本。使用纸片扩散法进行抗菌药物敏感性试验。

结果

100 个样本中,39 个(39%)样本中鉴定出铜绿假单胞菌,10 个(10%)样本中鉴定出金黄色葡萄球菌。在 12 周的治疗期末,PRP 组(P =.0078)和对照组(P =.01)的伤口感染均减少。在研究期间,大多数测试的抗菌药物对微生物均敏感。PRP 并未增加伤口中的细菌载量。鉴定出的所有金黄色葡萄球菌均具有生物膜形成能力,被归类为弱生物膜生产者。所有铜绿假单胞菌均产生生物膜,其中 17 株为弱生物膜生产者,14 株为中度生物膜生产者,8 株为强生物膜生产者。

结论

与单独使用凡士林纱布相比,PRP 联合凡士林纱布并未增加慢性静脉溃疡的细菌生长或微生物载量,可被视为治疗此类慢性伤口的一种先进治疗选择。

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