Xu Yuanling, Li Yongsheng, Yu Kangmin, Chen Zhiyong, Shen Yun, Zha Binshan, Zhang Hong, Xu Qianqian, Zhao Hong
Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University Hefei 230022, Anhui, China.
Wound Stoma Care Outpatient Center, The First Affiliated Hospital of Anhui Medical University Hefei 230022, Anhui, China.
Am J Transl Res. 2022 Apr 15;14(4):2452-2460. eCollection 2022.
To investigate the effects of silver foam combined with Dermlin wound healing dressing on concentrations of inflammatory factors of wound surface and quality of life of the patients with diabetic lower limb ulcers.
A total of 60 patients with diabetic lower limb ulcers admitted to the First Affiliated Hospital of Anhui Medical University during January 2020 and December 2020 were retrospectively enrolled in this study. According to the different treatments, they were divided into a control group (30 cases treated with Dermlin wound healing dressing only), and a research group (30 cases treated with silver foam combined with Dermlin dressing). The clinical efficacy, wound healing status, pain intensity (visual analog scale (VAS) scores), concentrations of inflammatory factor (high-sensitivity C-reactive protein (hsCRP), leukocyte interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), procalcitonin (PCT)), angiogenesis factors levels (basic fibroblast growth factor (BFGF), vascular endothelial growth factor (VEGF)), oxidative stress reaction indexes (advanced protein oxidation products (AOPP), malondialdehyde (MDA) and superoxide dismutase (SOD)) and quality of life (SF-36 scale) were compared between two groups. The bacterial removal rate was calculated based on the results of bacterial culture before and after treatment. The central granulated tissue was collected after the granulation tissue coverage rate was calculated.
The research group had significantly higher overall response rate (96.67% vs 73.33%), shorter wound healing time and higher wound healing rate than the control group (all P<0.05). The VAS scores were decreased in both Groups 1, 3 and 7 d after treatment as compared with those before treatment, and the VAS scores were significantly lower in the research group than in the control group during the same period (all P<0.05). After treatment, the concentrations of hsCRP, IL-6, TNF-α, PCT, AOPP and MDA were decreased in both groups, while the levels of bFGF, VEGF, l TGF-β1, SOD and SF-36 scores were increased significantly (all P<0.05). The above-mentioned indicators of the research group improved significantly compared with those of the control group (all P<0.05). The bacterial removal rate and granulation tissue coverage rate of the research group were significantly higher than those of the control group (both P<0.05).
The treatment of diabetic lower limb ulcers with silver foam combined with Dermlin dressing can effectively promote wound healing, reduce pain intensity, and improve quality of life in patients with diabetic lower limb ulcers. Such effects may be attributed to lower levels of inflammatory factor levels, regulation of oxidative stress, and improvement of angiogenesis.
探讨银泡沫联合德莫林伤口愈合敷料对糖尿病下肢溃疡患者创面炎症因子浓度及生活质量的影响。
回顾性纳入2020年1月至2020年12月在安徽医科大学第一附属医院收治的60例糖尿病下肢溃疡患者。根据治疗方法不同，将其分为对照组（30例仅用德莫林伤口愈合敷料治疗）和研究组（30例用银泡沫联合德莫林敷料治疗）。比较两组的临床疗效、伤口愈合情况、疼痛强度（视觉模拟评分（VAS））、炎症因子浓度（高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT））、血管生成因子水平（碱性成纤维细胞生长因子（BFGF）、血管内皮生长因子（VEGF））、氧化应激反应指标（晚期蛋白氧化产物（AOPP）、丙二醛（MDA）和超氧化物歧化酶（SOD））及生活质量（SF-36量表）。根据治疗前后细菌培养结果计算细菌清除率。计算肉芽组织覆盖率后收集中央肉芽组织。
研究组总有效率显著高于对照组（96.67%对73.33%），伤口愈合时间短，伤口愈合率高（均P<0.05）。治疗后第1、3和7天两组VAS评分均较治疗前降低，且同期研究组VAS评分显著低于对照组（均P<0.05）。治疗后，两组hsCRP、IL-6、TNF-α、PCT、AOPP和MDA浓度均降低，而bFGF、VEGF、l TGF-β1、SOD水平及SF-36评分显著升高（均P<0.05）。研究组上述指标较对照组改善显著（均P<0.05）。研究组细菌清除率和肉芽组织覆盖率显著高于对照组（均P<0.05）。
银泡沫联合德莫林敷料治疗糖尿病下肢溃疡可有效促进伤口愈合，减轻疼痛强度，改善糖尿病下肢溃疡患者生活质量。这些作用可能归因于炎症因子水平降低、氧化应激调节及血管生成改善。
