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评估糖尿病足感染患者行持续冲洗封闭式负压引流时使用抗菌溶液冲洗与生理盐水冲洗的效果。

Assessment between antiseptic and normal saline for negative pressure wound therapy with instillation and dwell time in diabetic foot infections.

机构信息

Department of Burn Surgery, the First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021, People's Republic of China.

出版信息

Sci Rep. 2024 May 19;14(1):11423. doi: 10.1038/s41598-024-58900-3.

DOI:10.1038/s41598-024-58900-3
PMID:38763922
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11102898/
Abstract

Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is increasingly used for a diverse range of wounds. Meanwhile, the topical wound irrigation solution consisting of polyhexamethylene biguanide and betaine (PHMB-B) has shown efficacy in managing wound infections. However, the effectiveness of this solution as a topical instillation solution for NPWTi-d in patients with diabetic foot infections (DFIs) has not been thoroughly studied. The objective of this retrospective study was to evaluate the impact of using PHMB-B as the instillation solution during NPWTi-d on reducing bioburden and improving clinical outcomes in patients with DFIs. Between January 2017 and December 2022, a series of patients with DFIs received treatment with NPWTi-d, using either PHMB-B or normal saline as the instillation solution. Data collected retrospectively included demographic information, baseline wound characteristics, and treatment outcomes. The study included 61 patients in the PHMB-B group and 73 patients in the normal saline group, all diagnosed with DFIs. In comparison to patients treated with normal saline, patients with PHMB-B exhibited no significant differences in terms of wound bed preparation time (P = 0.5034), length of hospital stay (P = 0.6783), NPWTi-d application times (P = 0.1458), duration of systematic antimicrobial administration (P = 0.3567), or overall cost of hospitalization (P = 0.6713). The findings of the study suggest that the use of either PHMB-B or normal saline as an instillation solution in NPWTi-d for DFIs shows promise and effectiveness, yet no clinical distinction was observed between the two solutions.

摘要

负压伤口治疗联合灌输和停留时间(NPWTi-d)越来越多地用于治疗各种伤口。同时,聚六亚甲基双胍和甜菜碱(PHMB-B)组成的局部伤口冲洗液在管理伤口感染方面显示出疗效。然而,这种溶液作为糖尿病足感染(DFIs)患者 NPWTi-d 的局部灌输溶液的有效性尚未得到充分研究。本回顾性研究的目的是评估在 NPWTi-d 中使用 PHMB-B 作为灌输溶液对降低生物负荷和改善 DFIs 患者临床结局的影响。在 2017 年 1 月至 2022 年 12 月期间,一系列 DFIs 患者接受了 NPWTi-d 治疗,使用 PHMB-B 或生理盐水作为灌输溶液。回顾性收集的数据包括人口统计学信息、基线伤口特征和治疗结果。该研究包括 PHMB-B 组的 61 例患者和生理盐水组的 73 例患者,所有患者均诊断为 DFIs。与生理盐水治疗的患者相比,PHMB-B 治疗的患者在伤口床准备时间(P=0.5034)、住院时间(P=0.6783)、NPWTi-d 应用次数(P=0.1458)、系统抗菌药物使用时间(P=0.3567)或总住院费用(P=0.6713)方面无显著差异。该研究结果表明,DFIs 患者在 NPWTi-d 中使用 PHMB-B 或生理盐水作为灌输溶液均有一定效果,但两种溶液之间未观察到临床差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d1/11102898/8916fc001d01/41598_2024_58900_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d1/11102898/8916fc001d01/41598_2024_58900_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d1/11102898/8916fc001d01/41598_2024_58900_Fig1_HTML.jpg

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