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下肢静脉溃疡的愈合率及愈合时间:对神经肌肉电刺激作为加压治疗辅助手段的一项真实世界服务评估

Healing Rate and Time to Closure of Venous Leg Ulcers: A Real-World Service Evaluation of Neuromuscular Electrostimulation as an Adjunct to Compression Therapy.

作者信息

Murray Holly, Duong Rochelle, Bain Duncan Shirreffs

机构信息

Holly Murray, BNSc, RN, WOCN, NSWOC, WOCC(C), is Registered Nurse and Nurse Specialized in Wound, Ostomy and Continence, Spectrum Health Care, Mississauga, Ontario, Canada. Rochelle Duong, MHA, BScN, RN, is Director, Clinical Operations and Client Solutions, Aetonix, a division of Trudell Medical, London, Ontario. Duncan Shirreffs Bain, PhD, is Consultant, Bain Consulting, Hertfordshire, UK, and is a paid consultant to Firstkind Ltd. The authors have disclosed no other financial relationships related to this article. Submitted June 13, 2024; accepted in revised form December 19, 2024.

出版信息

Adv Skin Wound Care. 2025 Jun 1;38(5):246-250. doi: 10.1097/ASW.0000000000000299. Epub 2025 Apr 1.

Abstract

OBJECTIVE

To perform a service evaluation of neuromuscular electrostimulation (NMES) as an adjunct to compression therapy, comparing the rate of wound margin advance and time to closure with a matched retrospective control group.

METHODS

Fifteen patients with venous leg ulcers were prescribed NMES for 6 hours per day for 56 days or until wound closure (whichever occurred first), in addition to multilayer compression. Wounds were selected for size, with an inclusion criterion of a maximum of 12 cm 2 . Wound progress was compared with 15 retrospective control patients who were matched for ulcer size and duration.

RESULTS

The retrospective group had a healing rate of 0.31 mm per week (95% CI, 29-37 mm/week), whereas the prospective compression plus NMES group had a healing rate of 0.56 mm per week (95% CI, 50-62 mm/week; P = .004). All wounds in both groups healed completely during the service evaluation. Mean time to closure for the retrospective group was 77 days (95% CI, 66-88 days), whereas the NMES group had a mean time to closure of 40 days (95% CI, 37-43 days; P = .005).

CONCLUSIONS

Adding NMES of the common peroneal nerve to a care bundle including multicomponent compression resulted in significantly faster wound margin advance and significantly less time to heal in comparison with retrospective matched controls. Future randomized controlled trials or self-controlled studies of this approach would be of great interest to inform clinical practice.

摘要

目的

对神经肌肉电刺激(NMES)作为压迫疗法辅助手段进行服务评估,将伤口边缘进展率和愈合时间与匹配的回顾性对照组进行比较。

方法

15例下肢静脉溃疡患者除接受多层压迫治疗外,还每天接受6小时的NMES治疗,持续56天或直至伤口愈合(以先发生者为准)。根据伤口大小选择病例,纳入标准为最大面积为12平方厘米。将伤口进展情况与15例在溃疡大小和病程方面相匹配的回顾性对照患者进行比较。

结果

回顾性对照组的愈合速度为每周0.31毫米(95%可信区间,29 - 37毫米/周),而前瞻性压迫加NMES组的愈合速度为每周0.56毫米(95%可信区间,50 - 62毫米/周;P = 0.004)。在服务评估期间,两组所有伤口均完全愈合。回顾性对照组的平均愈合时间为77天(95%可信区间,66 - 88天),而NMES组的平均愈合时间为40天(95%可信区间,37 - 43天;P = 0.005)。

结论

与回顾性匹配对照组相比,在包括多成分压迫的护理方案中加入腓总神经的NMES可使伤口边缘进展明显加快,愈合时间明显缩短。未来对此方法进行随机对照试验或自身对照研究将对指导临床实践有很大意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e373/12244963/69d4e20a86c7/aswc-38-246-g001.jpg

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