Wong Natalie Shi Qi, Tan Audrey Hui Min, Chan Kai Siang, Goh Karine C C, Lai Peiting, Muthuveerappa Sivakami, Mohamed Nasir Mohamed Maliki Bin, Liang Shanying, Hong Qiantai, Yong Enming, Lo Zhiwen Joseph
Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore.
Wound and Stoma Care, Nursing Specialty Tan Tock Seng Hospital Singapore Singapore.
Health Sci Rep. 2023 Aug 23;6(8):e1488. doi: 10.1002/hsr2.1488. eCollection 2023 Aug.
Venous leg ulcers (VLUs) are associated with significant morbidity and poor quality of life (QOL). Compression therapy and wound dressing are the mainstay treatment options. Technology Lipido-Colloid Impregnated with Silver (TLC-Ag) reduces bacterial load and Technology Lipido-Colloid Nano-Oligosaccharide Factor (TLC-NOSF) reduces elevated matrix metalloproteinases and improve wound healing. However, evidence is scarce on the role of sequential therapy. This study aims to evaluate if sequential treatment with TLC-Ag and TLC-NOSF improves VLU wound healing and QOL.
This is a prospective cohort study from May 2020 to October 2021 on patients with VLUs who received sequential therapy, consisting of 2 weeks of TLC-Ag followed by two-layer compression bandage (2LB) with TLC-NOSF until complete wound healing. Participants were followed-up with weekly dressing changes. Our primary outcomes were wound area reduction (WAR) and Pressure Ulcer Scale of Healing (PUSH) score. Our secondary outcomes were QOL measures.
There were 28 patients with 57.1% males ( = 16) with a mean age of 65.3 years. Mean duration of VLU was 13.9 ± 11.7 weeks before the initiation of sequential therapy. Mean baseline wound area was 8.44 cm. Median time to wound healing was 10 weeks. 57.1% of patients achieved complete wound closure at 3 months. There was significant WAR after 1 month (mean area 8.44-5.81 cm, 31.2% decrease) and after 3 months (mean area 8.44-2.53 cm, 70.0% decrease). Mean monthly WAR was 28.9%. PUSH score also decreased at 1 month (16.5% decrease, < 0.001) and 3 months (63.3% decrease, < 0.001) marks following the sequential therapy. EuroQol Visual Analog Scale (EQ-VAS) improved following sequential therapy (baseline: 69.0 ± 15.0, week 13: 80.2 ± 13.2, < 0.001).
Sequential therapy with TLC-Ag followed by TLC-NOSF and 2LB is feasible, with good wound healing and improvement in QOL of patients with VLUs.
下肢静脉溃疡（VLU）与严重的发病率和生活质量（QOL）低下相关。加压治疗和伤口敷料是主要的治疗选择。含银脂质胶体技术（TLC-Ag）可降低细菌载量，含纳米低聚糖因子脂质胶体技术（TLC-NOSF）可降低升高的基质金属蛋白酶水平并促进伤口愈合。然而，关于序贯治疗作用的证据很少。本研究旨在评估TLC-Ag和TLC-NOSF序贯治疗是否能改善VLU伤口愈合和生活质量。
这是一项前瞻性队列研究，研究对象为2020年5月至2021年10月接受序贯治疗的VLU患者，治疗包括2周的TLC-Ag治疗，随后使用含TLC-NOSF的双层加压绷带（2LB）直至伤口完全愈合。参与者每周更换敷料并进行随访。我们的主要结局是伤口面积缩小（WAR）和愈合压力性溃疡量表（PUSH）评分。次要结局是生活质量指标。
共有28例患者，男性占57.1%（n = 16），平均年龄65.3岁。序贯治疗开始前VLU的平均病程为13.9±11.7周。平均基线伤口面积为8.44平方厘米。伤口愈合的中位时间为10周。57.1%的患者在3个月时实现伤口完全闭合。1个月后（平均面积从8.44平方厘米降至5.81平方厘米，减少31.2%）和3个月后（平均面积从8.44平方厘米降至2.53平方厘米，减少70.0%）伤口面积显著缩小。平均每月伤口面积缩小率为28.9%。序贯治疗后1个月（降低16.5%，P < 0.001）和3个月（降低63.3%，P < 0.001）时PUSH评分也降低。序贯治疗后欧洲五维度健康量表视觉模拟量表（EQ-VAS）有所改善（基线：69.0±15.0，第13周：80.2±13.2，P < 0.001）。
TLC-Ag联合TLC-NOSF和2LB的序贯治疗是可行的，能促进VLU患者伤口良好愈合并改善生活质量。
