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银基敷料对慢性伤口愈合的治疗效果分析

Analysis of therapeutic effect of silver-based dressings on chronic wound healing.

作者信息

Liang Kaitao, Liu Yan, Jiang Fengting

机构信息

Trauma Orthopedics Department, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, China.

Intensive Care Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China.

出版信息

Int Wound J. 2024 Aug;21(8):e70006. doi: 10.1111/iwj.70006.

Abstract

Chronic wounds are susceptible to bacterial infections and at high risk of developing antibiotic-resistant bacterial infections. Silver is an antimicrobial by targeting almost all types of bacteria in chronic wounds to reduce the bacterial load in the infected area and further facilitate the healing process. This study focused on exploring whether silver-based dressings were superior to non-silver dressings in the treatment of chronic wounds. PubMed, Web of Science and Embase were comprehensively searched from inception to March 2024 for randomized clinical trials and observational studies. The endpoints in terms of wound healing rate, complete healing time, reduction on wound surface area and wound infection rate were analysed using Review Manager 5.4 software. A total of 15 studies involving 5046 patients were eventually included. The results showed that compared with patients provided with non-silver dressings, patients provided with silver-based dressings had higher wound healing rate (OR: 1.43, 95% CI: 1.10-1.85, p = 0.008), shorter complete healing time (MD: -0.96, 95% CI: -1.08 ~ -0.85, p < 0.00001) and lower wound infection rate (OR: 0.56, 95% CI: 0.40-0.79, p = 0.001); no significant difference in the reduction on wound surface area (MD: 12.41, 95% CI: -19.59-44.40, p = 0.45) was found. These findings suggested that the silver-based dressings were able to enhance chronic wound healing rate, shorten the complete healing time and reduce wound infection rate, but had no significant improvement in the reduction on wound surface area. Large-scale and rigorous studies are required to confirm the beneficial effects of silver-based dressings on chronic wound healing.

摘要

慢性伤口易受细菌感染,且极易发展为耐抗生素细菌感染。银具有抗菌作用,它能针对慢性伤口中的几乎所有类型细菌,降低感染区域的细菌载量,进而促进愈合过程。本研究聚焦于探究银基敷料在慢性伤口治疗中是否优于非银敷料。从创刊至2024年3月,全面检索了PubMed、科学网和Embase数据库,以查找随机临床试验和观察性研究。使用Review Manager 5.4软件分析伤口愈合率、完全愈合时间、伤口表面积减少情况和伤口感染率等终点指标。最终纳入了15项研究,涉及5046例患者。结果显示,与使用非银敷料的患者相比,使用银基敷料的患者伤口愈合率更高(比值比:1.43,95%置信区间:1.10 - 1.85,p = 0.008),完全愈合时间更短(平均差:-0.96,95%置信区间:-1.08至-0.85,p < 0.00001),伤口感染率更低(比值比:0.56,95%置信区间:0.40 - 0.79,p = 0.001);在伤口表面积减少方面未发现显著差异(平均差:12.41,95%置信区间:-19.59至44.40,p = 0.45)。这些发现表明,银基敷料能够提高慢性伤口愈合率,缩短完全愈合时间并降低伤口感染率,但在减少伤口表面积方面无显著改善。需要大规模、严谨的研究来证实银基敷料对慢性伤口愈合的有益作用。

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