摘要
目的探讨医用级蜂蜜敷料对非窦道型慢性感染创面愈合和疼痛的改善作用。方法选取2020年12月至2021年3月复旦大学金山医院伤口门诊就诊及病房住院的符合纳入标准的非窦道型慢性感染伤口患者105例纳入本次研究,按照随机数字表法均分为3组,A组采用医用级麦卢卡蜂蜜敷料,B组采用抗菌液体类敷料、C组采用藻酸盐银离子抗菌敷料。三组均在干预前、干预1 w、2 w、4 w、6 w对创面分泌物pH值、伤口细菌菌落数、坏死组织面积、伤口愈合面积、换药疼痛感等指标进行比较。结果各组随着干预时间的延长,其创面愈合面积也逐渐增大,创面分泌物pH值逐渐升高,呈上升趋势,差异有统计学意义(P<0.05),经单因素方差齐性检验发现,三组的创面愈合面积存在显著差异,两两比较,A组医用级蜂蜜敷料的应用对非窦道型慢性感染创面的促愈合作用较B、C组更为突出。此外,各组随着干预时间的延长,其坏死组织的面积也逐渐缩小,疼痛评分也逐渐下降,均呈显著下降趋势,差异有统计学意义(P<0.05);三组间差异显著,但以A组效果最好。此外,三组换药次数方面,组间差异显著,以A组换药次数最少;在周围皮肤评分方面,组间差异显著,以A组评分最好,差异有统计学意义(P<0.05)。干预1 w后,三组的伤口细菌菌落数显著较干预前低(A组12例低于B/C组),差异有统计学意义(P<0.05),且干预2 w及更长时间,三组均无伤口细菌菌落数阳性病例。结论医用级麦卢卡蜂蜜敷料在非窦道型慢性感染创面的修复中具有更为突出的愈合和疼痛的改善作用,能更好清除局部创面的定植菌、降低创面分泌物pH值、减少伤口细菌数量、缩短腐肉脱落时间,降低坏死组织面积,且敷料更换次数少,在三组材料的应用中具有突出的优势。
Objective To explore the effect of medical-grade honey dressing on wound healing and pain improvement of non-sinus chronic infection.Methods A total of 105 patients with non-sinus chronic infection wounds who met the inclusion criteria and were admitted to the wound clinic and ward of Jinshan Hospital of Fudan University from December 2020 to March 2021 were included in this study.They were divided into 3 groups according to random number table method.Group A was treated with medical-grade Manuka honey dressing.Antibacterial liquid dressing was used in Group B and alginate silver ion antibacterial dressing was used in Group C.The pH value of wound secretion,the number of bacterial colonies in the wound,the area of necrotic tissue,the area of wound healing and the pain of dressing change were compared among the three groups before intervention,1 week,2 weeks,4 weeks and 6 weeks.Results With the extension of intervention time,the wound healing area of each group also gradually increased,and the pH value of wound secretions gradually increased,showing an upward trend,and the difference was statistically significant(P<0.05).The univariate homogeneity of variance test showed that the wound healing area of the three groups was significantly different.Pairwise comparison showed that the application of medical-grade honey dressing in Group A had a more prominent promoting effect on the healing of non-sinus chronic infection wounds than that in Group B and Group C(P<0.05).In addition,with the extension of intervention time,the area of necrotic tissue in each group also gradually decreased,and the pain score also gradually decreased,showing a significant downward trend,and the differences were statistically significant(P<0.05).There were significant differences among the three groups,but Group A had the best effect.In addition,there were significant differences among the three groups in terms of dressing changes,with Group A having the least dressing changes.In terms of surrounding skin scores,there were significant differ
作者
戚晓霞
陈世红
常春雷
蔡蕴敏
Qi Xiaoxia;Chen Shihong;Chang Chunlei;Cai Yunmin(Wound Treatment Center,Jinshan Hospital of Fudan University,Shanghai 201508,China)
出处
《国际护理学杂志》
2023年第6期1048-1053,共6页
international journal of nursing
基金
上海金山区卫生健康系统"优秀青年人才"培养计划(JSYQ201902)。
