负压创面技术联合抗细菌生物膜材料治疗慢性创面的效果观察

Clinical analysis of the treatment of chronic wounds with closed negative pressure wound therapy combined with anti-bacterial biofilm dressing

目的观察负压创面技术联合抗细菌生物膜材料治疗慢性创面的临床效果方法将符合纳入标准的73例患者按照随机数字表法分为对照组36例和干预组37例,对照组采用0.9%的藻酸银敷料作为一级敷料,而干预组的一级敷料改进为银抗菌伤口敷料,2组患者均以负压持续治疗14天后采用湿性平衡治疗至愈合,并随访2个月。结果治疗前2组患者基线比较差异无统计学意义(P>0.05)。①2组患者治疗后第7天,创面面积无统计学意义(P>0.05);②治疗后第14天干预组创面面积,细菌阳性率均显著低于对照组(P<0.05);③2组患者在治疗后的疼痛评分在不同时间节点均呈现下降趋势(P<0.05),并且干预组疼痛评分较对照组显著降低(P<0.05);④干预组创面治愈率,压创愈合计万表(PUSH)计分,住院时间均显著优于对照组(P<0.05)。结论银抗菌伤口敷料结合NPWT能够有效缩小创面面积,控制创面细菌感染,提高创面愈合率,减缓创面疼痛,缩短住院时间。

Objective To observe the effectiveness of anti-bacterial biofilm dressing(Aquacel Ag+extra) combined with negative pressure wound therapy in the treatment of chronic wounds.Methods Seventy-three patients who met the inclusion criteria were divided into the control group(36 cases)and the intervention group(37cases)according to the random number table method.The control group was treated with silver alginate dressing as the primary dressing,while the intervention group was treated with Aquacel Ag+extra as the primary dressing.All patients were treated with negative pressure at least 14 days,and then were treated with moist wound therapy until wound healed or followed up for 2 months.Results Baseline comparison between the two groups before treatment was not statistically significant(P>0.05).After 7 days of treatment,there was no statistical significance in the comparison of wound area between the two groups(P>0.05).After 14 days of treatment,the wound area and depth and bacterial positive rate of the intervention group were significantly lower than those of the control group(P<0.05).After treatment,the pain score of the 2 groups showed a downward trend at different time nodes(P<0.05),and the pain score of the intervention group was significantly lower than that of the control group(P<0.05).The cure rate of wounds,pressure ulcer scale for healing score and hospital stay of the intervention group were significantly better than those of the control group(P<0.05).Conclusion Aquacel Ag+extra combined with negative pressure wound therapy can effectively reduce the wound area,control the wound bacterial infection,improve the wound healing rate,relieve the wound pain and shorten the hospital stay.