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A Retrospective Analysis of Acoustic Pressure Wound Therapy: Effects on the Healing Progression of Chronic Wounds 声压创面治疗对慢性创面愈合进展的影响
Pub Date : 2009-01-01 Epub Date: 2009-05-21 DOI: 10.1016/j.jcws.2008.11.001
Jaimee Haan PT, CWS , Sharon Lucich PT, CWS

Background

Small clinical studies suggest adjunctive use of acoustic pressure wound therapy (APWT) may enhance wound healing, even in challenging patients. This noncontact low-frequency, nonthermal ultrasound therapy for assisting with the debridement of necrotic tissue from challenging wounds is generally better tolerated by patients for whom treatment-related wound pain, anticoagulation, or medical instability precludes sharp, surgical, or mechanical debridement.

Objective

To evaluate changes in amount of devitalized tissue, amount and type of wound drainage, and wound surface area after administration of APWT.

Design

Retrospective chart review of 48 consecutive patients treated with adjunctive APWT at a single center between January 2006 and October 2007.

Methods

Paired comparisons of baseline versus posttreatment values for wound area, tissue characteristics, drainage, and pain were analyzed. Time, frequency, and duration of APWT and treatment-related adverse events were collected.

Results

APWT was administered a mean of 2.1 times per week for a mean of 4.1 minutes per session. Mean duration of therapy was 5.5 weeks. Median wound area was reduced by 92% from baseline to end of APWT (6.2 cm2 to 0.2 cm2,P < .0001). The proportion of wounds with >75% granulation tissue increased from 37% to 89% (P < .0001). The proportion of wounds without fibrin slough or eschar increased from 31% to 75% (P < .0001) and from 72% to 94% (P = .02), respectively.

Limitations

Retrospective design, lack of control group, small sample population.

Conclusion

As an adjunct to conventional wound management, APWT appears to improve parameters associated with wound healing, including increased tissue granulation, decreased necrotic tissue, and decreased wound area.

背景:小型临床研究表明,声压创面治疗(APWT)的辅助使用可以促进创面愈合,即使是在困难的患者中。这种非接触式低频率、非热超声治疗用于协助对挑战性伤口的坏死组织进行清创,对于那些因治疗相关的伤口疼痛、抗凝或医疗不稳定而无法进行尖锐、手术或机械清创的患者来说,通常耐受性更好。目的评价应用APWT后失活组织数量、创面引流液数量和类型及创面面积的变化。设计回顾性分析2006年1月至2007年10月在同一中心接受辅助APWT治疗的48例患者。方法比较基线和治疗后的伤口面积、组织特征、引流和疼痛值。收集APWT发生的时间、频率、持续时间以及与治疗相关的不良事件。结果apwt治疗平均每周2.1次,每次4.1分钟。平均治疗时间为5.5周。从基线到APWT结束时,中位伤口面积减少了92%(从6.2 cm2减少到0.2 cm2,P <。)。75%肉芽组织的伤口比例从37%增加到89% (P <。)。无纤维蛋白脱落或结痂的创面比例从31%增加到75% (P <.0001)和72% ~ 94% (P = .02)。局限性:回顾性设计,缺乏对照组,样本量小。结论:作为常规伤口处理的辅助手段,APWT可以改善与伤口愈合相关的参数,包括增加组织肉芽,减少坏死组织和减少伤口面积。
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引用次数: 9
Letter from the Chair of the ACCWS ACCWS主席的信
Pub Date : 2009-01-01 Epub Date: 2009-05-21 DOI: 10.1016/j.jcws.2008.12.002
Richard Simman MD, CWS, FACCWS
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引用次数: 0
A Primer on Wound Bed Preparation 创伤床准备入门
Pub Date : 2009-01-01 Epub Date: 2009-05-21 DOI: 10.1016/j.jcws.2008.10.001
Chuck Gokoo MD, CMO CWS, FACCWS

Successful wound closure and healing are a major concern for today's clinician. Determining if the wound will progress or not relies on a comprehensive assessment, recognition of wound characteristics that will promote or impede the healing process and preparing the wound bed such that pathological features are removed allowing the healing cascade to occur. When complications are no longer a roadblock the wound will achieve a stable microenvironment and progress through the normal repairative process.

成功的伤口闭合和愈合是当今临床医生关注的主要问题。确定伤口是否会进展取决于综合评估,对促进或阻碍愈合过程的伤口特征的认识,以及准备伤口床,以便去除病理特征,允许愈合级联发生。当并发症不再是障碍时,伤口将获得稳定的微环境,并通过正常的修复过程进行。
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引用次数: 10
Wound Closure and the Reconstructive Ladder in Plastic Surgery 整形外科中的伤口闭合与重建阶梯
Pub Date : 2009-01-01 Epub Date: 2009-05-21 DOI: 10.1016/j.jcws.2008.10.003
Richard Simman MD, CWS, FACCWS

Wound closure requires deep understanding of wound physiology, anatomy, and the healing phase of the wound. The basic principles of wound closure, diabetes control, normal nutrition status, infection control, mechanical stress avoidance, and nursing care are all important elements in achieving healing of acute and chronic wounds. This goal is achievable only through the interdisciplinary approach to wound healing. A number of wound closure techniques are available to the plastic surgeon. This armamentarium includes a variety of techniques, from simple primary wound closure to more-sophisticated and -costly flap reconstructive techniques. This article summarizes the components of the reconstructive ladder for wound closure that are available to the reconstructive surgeon.

伤口闭合需要对伤口生理学、解剖学和伤口愈合阶段有深入的了解。创面闭合的基本原则、糖尿病的控制、正常的营养状况、感染的控制、机械应力的避免和护理都是实现急慢性创面愈合的重要因素。这一目标只有通过跨学科的伤口愈合方法才能实现。整形外科医生可以使用许多缝合伤口的技术。该设备包括多种技术,从简单的初级伤口闭合到更复杂和昂贵的皮瓣重建技术。本文总结了重建外科医生可使用的伤口闭合重建阶梯的组成部分。
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引用次数: 54
Interview With Pamela Scarborough 采访帕梅拉·斯卡伯勒
Pub Date : 2009-01-01 Epub Date: 2009-05-21 DOI: 10.1016/j.jcws.2008.08.002
Kari Bechert BA, MPT, CWS, FACCWS
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引用次数: 0
期刊
The journal of the American College of Certified Wound Specialists
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