Thomas Deena Clare, Tsu Chong Li, Nain Rose A, Arsat Norkiah, Fun Soong Shui, Sahid Nik Lah Nik Amin
Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia.
Department of Surgery, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia.
Ann Med Surg (Lond). 2021 Oct 4;71:102876. doi: 10.1016/j.amsu.2021.102876. eCollection 2021 Nov.
To provide an overview of the types of wound debridement and update the available scientific consensus on the effect of wound debridement.
The articles were searched through CINAHL, PubMed, Cochrane Library, and Medline database for relevant articles on all types of wound debridement. Articles included were all systematic review on the effectiveness of wound debridement-related outcome, published within the year 2017 until Aug 2021, in English.
A total of seven scientific articles had been selected for review out of 318 screened. The authors reviewed a total of 318 titles and abstracts related to wound debridement effectiveness. Seven articles that were selected were narratively reviewed by two authors. The findings of the review were organized into autolytic, enzymatic, sharp, surgical, biological, and mechanical debridement methods and includes the advantages and disadvantages of each. The author further explored on the role of wound debridement according to wound bed preparation model. Articles were synthesized and organized based on the authors, year, total studies included in the systematic review, study range of year, total sample, debridement method, wound types, and findings.
Maggot debridement therapy showed a consistent finding in terms of effectiveness in debriding chronic wounds. The newer debridement method includes hydro-surgery, low-frequency ultrasonic and enzymatic collagenase debridement were getting more attention due to faster wound bed preparation and less painful. However, these newer method of debridements showed inconclusive findings and the patient safety was not clearly defined. A higher level of review is warranted in the future study.
概述伤口清创的类型,并更新关于伤口清创效果的现有科学共识。
通过CINAHL、PubMed、Cochrane图书馆和Medline数据库搜索有关所有类型伤口清创的相关文章。纳入的文章均为2017年至2021年8月期间发表的关于伤口清创相关结局有效性的英文系统评价。
在筛选的318篇文章中,共选出7篇科学文章进行综述。作者共审查了318篇与伤口清创效果相关的标题和摘要。两位作者对选出的7篇文章进行了叙述性综述。综述结果按照自溶性、酶性、锐性、手术性、生物性和机械性清创方法进行整理,并包括每种方法的优缺点。作者根据伤口床准备模型进一步探讨了伤口清创的作用。文章根据作者、年份、系统评价中纳入的研究总数、年份研究范围、总样本、清创方法、伤口类型和研究结果进行综合和整理。
蛆虫清创疗法在清创慢性伤口的有效性方面显示出一致的结果。由于能更快地准备伤口床且疼痛较轻,较新的清创方法包括水刀手术、低频超声和酶性胶原酶清创越来越受到关注。然而,这些较新的清创方法结果尚无定论,且患者安全性尚不明确。未来的研究需要更高水平的综述。