摘要
目的:研究银离子敷料覆盖联合负压吸引(Vacuum-assisted closure,VAC)在慢性难愈性创面修复患者中的应用效果。方法:选择笔者医院2016年3月-2020年9月诊治的98例慢性难愈性创面患者,随机数表法分为对照组(49例)和研究组(49例),前者给予传统治疗,后者给予银离子敷料覆盖联合VAC治疗。比较两组患者治疗前后创面感染、组织再上皮化、创面瘢痕情况变化,并评估疼痛程度,统计敷料更换和创面恢复情况。结果:治疗前两组患者细菌培养阳性率、C反应蛋白(C-reactive protein,CRP)、基质金属蛋白酶2(Matrix metalloproteinase-2,MMP-2)以及红细胞沉降率(ESR)水平、瘢痕评分比较无显著差异(P>0.05),治疗后研究组上述指标水平均降低,且低于对照组,差异有统计学意义(P<0.05);治疗前两组患者转化生长因子β1(TGF-β1)和血管内皮生长因子(VEGF)水平比较无显著差异(P>0.05),治疗后研究组上述指标水平均升高,且高于对照组,差异有统计学意义(P<0.05);治疗前两组患者疼痛评分比较无显著性差异(P>0.05),治疗后7 d、14 d、1个月研究组评分明显降低,且低于对照组,差异有统计学意义(P<0.05);研究组患者敷料更换次数、创面肉芽组织生长、上皮形成以及愈合时间明显低于对照组,差异有统计学意义(P<0.05)。结论:银离子敷料覆盖联合VAC技术可较好的控制创面感染、促进组织再上皮化的形成,同时有利于减轻疼痛和瘢痕,促进创面更好的愈合恢复。
Objective To study the application of silver ion dressing coverage combined with vacuum-assisted closure(VAC)in patients undergoing chronic refractory wound repair.Methods A total of 98 patients with chronic refractory wounds treated in the hospital were enrolled in this study between March 2016 to September 2020.They were divided into control group(49 cases,traditional treatment)and study group(49 cases,silver ion dressings coverage combined with VAC)by random number table method.The changes in wound infection,tissue re-epithelization and wound scars before and after treatmentwere compared between the two groups.The pain degree was evaluated,dressing changes and wound recovery were statistically analyzed.Results Before treatment,there was no significant difference in positive rate of bacterial culture,levels of C-reactive protein(C-reaction protein,CRP),matrix metalloproteinase-2(MMP-2)and erythrocyte sedimentation rate(ESR),and scar score between the two groups(P>0.05).After treatment,the above indexes in study group were decreased,lower than those in control group(P<0.05).Before treatment,there was no significant difference in the levels of transforming growth factorβ1(TGF-β1)and vascular endothelial growth factor(VEGF)between the two groups(P>0.05),and the above indexes in study group were increased after treatment,higher than those in control group(P<0.05).Before treatment,there was no significant difference in pain scorebetween the two groups(P>0.05).At 7d,14d and 1 month after treatment,the score in study group was significantly decreased,lower than that in control group(P<0.05).The times of dressing changes,growth of wound granulation tissues,epithelization and healing time in study group were significantly lower than those in control group(P<0.05).Conclusion Silver ion dressings coverage combined with VAC can better control wound infection,and promote tissue re-epithelialization,which is beneficial to reduce pain and scars,and promote better healing and recovery of wounds.
作者
马少君
栾文康
刘圣洁
阮鸿儒
卢峰
王金龙
MA Shaojun;LUAN Wenkang;LIU Shengjie;RUAN Hongru;LU Feng;WANG Jinlong(Department of Burns and Plastic Surgery,People's Hospital of Jiangsu University,Zhenjiang 212000,Jiangsu,China)
出处
《中国美容医学》
CAS
2022年第1期23-26,共4页
Chinese Journal of Aesthetic Medicine
基金
国家自然科学基金青年项目(编号:81802726)。
关键词
银离子敷料
覆盖
负压吸引
慢性难愈性创面
感染
组织再上皮化
瘢痕
silver ion dressing
coverage
vacuum sealing drainage
chronic refractory wound
infection
tissue re-epithelialization
scar
