Department of Orthopaedics and Traumatology, Adana City Training and Research Hospital, Adana-Turkey.
Department of Plastic and Reconstructive Surgery, Adana City Training and Research Hospital, Adana-Turkey.
Ulus Travma Acil Cerrahi Derg. 2021 Nov;27(6):624-630. doi: 10.14744/tjtes.2020.38613.
To investigate the efficacy of new foams with boric acid particles combined with a negative pressure wound treatment (NPWT) system in open fractures with tissue defects secondary to trauma.
Forty-nine patients with open fractures secondary to trauma with soft tissue defects who were admitted between 2016 and 2018 were included in the study. Patients were examined in two groups. In Group 1, boric acid-impregnated foams combined with the NPWT system were used in 27 patients, and in Group 2, silver nitrate-impregnated foams combined with NPWT systems were used in 22 patients. In addition to evaluating the broad-spectrum antibacterial feature of silver nitrate, the antimicrobial, angiogenetic, and epithelializing effects of boric acid were investigated macroscopically and histopathologically.
A reduction in wound size and granulation was observed in each group. Macroscopically, the reduction in wound size, epithelialization and granulation were pronounced in Group 1 and in Group 2. Microscopically, the number of fibroblasts, collagen synthesis, and angiogenesis were significantly increased in Group 1 compared with Group 2.
In this clinical trial, both the broad spectrum antimicrobial feature of boric acid and its positive effect on the cells responsible for wound healing were found to be an alternative compared with silver nitrate. The use of new foams with boric acid particles combined with the NPWT system may be a good alternative method in the treatment of open wounds due to trauma.
研究硼酸颗粒联合负压伤口治疗（NPWT）系统的新型泡沫在创伤后软组织缺损的开放性骨折中的疗效。
研究纳入 2016 年至 2018 年间收治的 49 例创伤后软组织缺损的开放性骨折患者。患者分为两组，在第 1 组中，使用硼酸浸渍泡沫联合 NPWT 系统治疗 27 例患者，在第 2 组中，使用硝酸银浸渍泡沫联合 NPWT 系统治疗 22 例患者。除了评估硝酸银的广谱抗菌特性外，还从宏观和组织病理学方面研究了硼酸的抗菌、血管生成和上皮化作用。
两组患者的创面均有缩小和肉芽形成。宏观上，第 1 组和第 2 组的创面缩小、上皮化和肉芽形成明显。显微镜下，第 1 组的成纤维细胞数量、胶原合成和血管生成明显高于第 2 组。
在这项临床试验中，与硝酸银相比，硼酸具有广谱抗菌作用，对参与伤口愈合的细胞也有积极作用，是一种替代治疗方法。使用硼酸颗粒联合 NPWT 系统的新型泡沫可能是创伤后开放性伤口治疗的一种良好替代方法。
