Bao Man-Zhen, Zhou Lian-Bang, Zhao Ling, Zhang Hui, Li Yuan, Yang Li, Tai An-Ting
Department of Nursing, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
World J Clin Cases. 2023 Oct 26;11(30):7277-7283. doi: 10.12998/wjcc.v11.i30.7277.
Chronic wounds that fail to progress through normal phases of healing present a significant healthcare burden owing to prolonged treatment and associated costs. Traditional wound care typically involves regular dressing changes, which can be painful. Recent approaches have explored the use of lidocaine to manage pain and red-light irradiation (RLI), known for its anti-inflammatory and cell proliferation effects, to potentially enhance wound healing.
To investigate the therapeutic efficacy of lidocaine wet compression (LWC) combined with RLI for chronic wounds.
We enrolled 150 patients with chronic wounds from the Wound and Ostomy Outpatient Clinic of the Second Hospital of Anhui Medical University from April to September 2022. The wounds were treated with dressing changes. The patients were randomly assigned to the control and experimental groups using a random number table and given the same first dressing change (2% LWC for 5 min and routine dressing change). From the second dressing change, in addition to 2% LWC for 5 min and routine dressing change, the experimental group received RLI, whereas the control group continued to receive the same LWC and dressing change. The first and second dressing changes were performed on days 1 and 2, respectively. The third dressing change was performed 3 d after the second change. The frequency of subsequent dressing changes was determined based on wound exudation and pain. Pain during the first three dressing changes was evaluated in both groups. The average number of dressing changes within 28 d and the degree of wound healing on day 28 were also recorded.
During the initial dressing change, no noticeable differences were observed in the pain levels experienced by the two groups, indicating similar pain tolerance. However, during the second and third dressing changes, the experimental group reported significantly less pain than the control group. Furthermore, over 28 d, the experimental group required fewer dressing changes than the control group.
Notably, the effectiveness of wound healing on the 28 day was significantly higher in the experimental group than that of in the control group. The combination of LWC and RLI was effective in reducing early-stage pain, promoting wound healing, decreasing the frequency of dressing changes, and enhancing patients' overall quality of life with chronic wounds.
由于治疗时间延长和相关费用，未能经历正常愈合阶段的慢性伤口带来了巨大的医疗负担。传统的伤口护理通常包括定期更换敷料，这可能会很痛苦。最近的方法探索了使用利多卡因来管理疼痛以及利用以抗炎和细胞增殖作用而闻名的红光照射（RLI）来潜在地促进伤口愈合。
研究利多卡因湿敷（LWC）联合RLI治疗慢性伤口的疗效。
我们于2022年4月至9月从安徽医科大学第二附属医院伤口造口门诊招募了150例慢性伤口患者。伤口采用更换敷料进行治疗。使用随机数字表将患者随机分为对照组和实验组，并给予相同的首次换药（2%利多卡因湿敷5分钟并进行常规换药）。从第二次换药开始，除了2%利多卡因湿敷5分钟并进行常规换药外，实验组接受红光照射，而对照组继续接受相同的利多卡因湿敷和换药。第一次和第二次换药分别在第1天和第2天进行。第三次换药在第二次换药后3天进行。后续换药频率根据伤口渗出情况和疼痛程度确定。两组均评估了前三次换药时的疼痛情况。还记录了28天内的平均换药次数以及第28天的伤口愈合程度。
在首次换药期间，两组患者经历的疼痛水平没有明显差异，表明疼痛耐受性相似。然而，在第二次和第三次换药期间，实验组报告的疼痛明显低于对照组。此外，在28天内，实验组所需的换药次数少于对照组。
值得注意的是，实验组在第28天的伤口愈合效果明显高于对照组。利多卡因湿敷联合红光照射在减轻早期疼痛、促进伤口愈合、减少换药频率以及提高慢性伤口患者的整体生活质量方面是有效的。
