Effects of Hypochlorous Acid Solutions on Venous Leg Ulcers (VLU): Experience With 1249 VLUs in 897 Patients

Cheryl M. Bongiovanni PhD, RVT, CWS, FASA, FACCWS
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引用次数: 12

Abstract

In order to assess the impact of comorbidities and identify factors that accelerate the healing rate of venous leg ulcers we performed an extensive, retrospective analysis of our experience in a diverse population. From June, 2006 to June, 2014, 897 patients with 1249 venous leg ulcers were treated at Lake Wound Clinics. Treatment protocols utilized the standard regimen of wound cleaning, debridement and compression bandaging. Wound cleaning, autolytic debridement, packing and dressing of venous leg ulcers utilized aqueous solutions of hypochlorous acid (HCA) rather than the standard normal saline. This protocol caused all ulcers to close completely. Comorbidities that delayed healing included uncontrolled or poorly controlled diabetes mellitus, advanced peripheral artery occlusive disease (PAD), active smoking, use of steroid medications and/or street drugs, large initial ulcer size and significant depth. Other factors, including advanced age, recurrent venous ulceration, stasis dermatitis, lipodermatosclerosis, morbid obesity and infection with one or more multidrug resistant organisms did not delay closure. From this experience we conclude that venous leg ulcer care protocols that clean, debride, pack and dress with hypochlorous acid solutions can reduce the effects of some comorbidities while accelerating healing times. Additional benefits are described.

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次氯酸溶液对静脉下肢溃疡(VLU)的影响:897例1249例VLU患者的经验
为了评估合并症的影响,并确定加速下肢静脉性溃疡愈合的因素,我们对不同人群的经验进行了广泛的回顾性分析。2006年6月至2014年6月,Lake Wound Clinics共收治897例下肢静脉性溃疡患者1249例。治疗方案采用标准的伤口清洗、清创和压缩包扎方案。伤口清洗、自溶清创、填塞和包扎下肢静脉溃疡使用次氯酸(HCA)水溶液而不是标准生理盐水。该方案使所有溃疡完全闭合。延迟愈合的合并症包括未控制或控制不良的糖尿病、晚期外周动脉闭塞性疾病(PAD)、积极吸烟、使用类固醇药物和/或街头药物、初始溃疡大且深度显著。其他因素,包括高龄、复发性静脉溃疡、瘀血性皮炎、脂质皮肤硬化、病态肥胖和一种或多种多重耐药生物感染,都没有延迟闭合。根据这一经验,我们得出结论,静脉下肢溃疡护理方案,清洁,清创,包装和包扎次氯酸溶液可以减少一些合并症的影响,同时加快愈合时间。还描述了其他好处。
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