波哥大一家公立医院使用水纤维敷料治疗复杂伤口的管理(哥伦比亚)

M. A. Salazar Trujillo
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摘要

目标。评价上一代含银纤维敷料用于治疗难以愈合的复杂伤口的疗效。材料和研究方法。开展了一项前瞻性观察性病例-随访研究,纳入了在哥伦比亚波哥大一家公立医院整形外科部门接受治疗的急性或慢性伤口难以愈合的患者,他们使用银离子、苄索氯铵和EDTA (Aquacel Agplus®,ConvaTec)增强的纤维敷料进行愈合。对创面进行监测,评估感染控制、渗出液和生物膜,以及所需敷料的次数和完全闭合创面所需的时间。研究的结果。共纳入55例患者,中位年龄44岁。在所有病例中,都进行了随访,直到伤口完全愈合。在研究结束时,我们观察到,在35例(63.6%)患者中,伤口在平均59.3天内演变为第二次愈合,需要12.5次敷料。20例(36.4%)患者在平均31.4天内,用移植物、皮瓣或真皮替代品进行了充分的伤口床准备,平均需要6.5次敷料(60.0%)伤口感染,平均使用5次敷料即可达到适当的感染控制。6次敷料后生物膜的直接和间接体征均有明显下降。结果表明,该敷料能有效地控制渗出、感染和生物膜,并为最终的手术覆盖做好准备。
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Management of complex wounds treatment with a hydrofiber dressing in a public hospital in Bogota (Colombia)
Objective. To evaluate the efficacy of the use of a last generation hydrofiber dressing with silver, for the treatment of complex wounds that are difficult to heal.Materials and research methods. A prospective observational case-follow-up study was carried out, which included patients with acute or chronic wounds that were difficult to heal, treated in the plastic surgery service of a public hospital in Bogota-Colombia, who underwent healing with hydrofiber dressings reinforced, with silver ions, benzethonium chloride and EDTA (Aquacel Agplus®, ConvaTec). The wound was monitored, evaluating infection control, exudate and biofilm, as well as the number of required dressings and the time required for the complete closure of the wound.Research results. A total of 55 patients were included, with a median age of 44 years. In all cases, a follow-up was carried out until the definitive closure of the wound. At the end of the study, it was observed that, in 35 (63.6 %) patients, the wounds evolved to complete closure by second intention in an average of 59.3 days, requiring 12.5 dressings. 20 (36.4 %) patients had adequate wound bed preparation for definitive surgical coverage with grafts, flaps or dermal substitutes, in an average of 31.4 days, requiring 6.5 dressings on average.33 (60.0 %) wounds were infected and adequate infection control was achieved on average with 5 dressings. A decrease in the direct and indirect signs of biofilm was achieved after 6 dressings.Conclusion. The results show that the dressing studied is effective to control exudate, infection and biofilm, as well as to prepare the bed for a definitive surgical coverage.
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