Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the unc...Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the uncertainty of therapeutic success and wound progression.The aim of this study was to investigate the clinical impact of a next-generation anti-biofilm Hydrofiber wound dressing(AQUACEL Ag+Extra[AQAg+E])in hard-to-heal wounds that had previously been treated unsuccessfully with traditional silver-,iodine-or polyhexamethylene biguanide(PHMB)-containing dressings and products and/or systemic antibiotics.Methods:Clinical case study evaluations of the anti-biofilm dressing were conducted,where deteriorating or stagnant wounds were selected by clinicians and primary dressings were replaced by the anti-biofilm dressing for up to 4 weeks,or as deemed clinically appropriate,with monitoring via case report forms.The data was stratified for cases where traditional silver-,iodine-or PHMBcontaining products,or systemic antibiotics,had been used prior to the introduction of the antibiofilm dressing.Results:Sixty-five cases were identified for inclusion,wounds ranging in duration from 1 week to 20 years(median:12 months).In 47(72%)cases the wounds were stagnant,while 15(23%)were deteriorating;3 wounds were not recorded.After an average of 4.2 weeks of management with the anti-biofilm dressing(range:1–11 weeks),in 11(17%)cases the wounds had healed(i.e.complete wound closure),40(62%)wounds improved,9(14%)wounds remained the same and 5(8%)wounds deteriorated.Conclusions:The introduction of this anti-biofilm dressing into protocols of care that had previously involved wound management with traditional antimicrobial products and/or antibiotics was shown to facilitate improvements in the healing status of most of these hard-to-heal wounds.Dressings containing proven anti-biofilm technology,in combination with antimicrobial silver and exudate management technology,appear to be an effective alternative to traditional anti展开更多
目的系统评价银离子类敷料治疗慢性难愈性创面的促愈、减痛效果和安全性。方法计算机检索从建库至2022年9月6日PubMed、The Cochrane Library、Embase、Web of Science、中国知网、中国生物医学文献数据库、万方数据库及维普数据库中,...目的系统评价银离子类敷料治疗慢性难愈性创面的促愈、减痛效果和安全性。方法计算机检索从建库至2022年9月6日PubMed、The Cochrane Library、Embase、Web of Science、中国知网、中国生物医学文献数据库、万方数据库及维普数据库中,关于银离子类敷料治疗慢性难愈性伤口的随机对照试验。经2名研究人员独立筛选文献、提取资料与评价文献质量后,应用Revman5.4软件行Meta分析。结果筛选后最终纳入21篇文献,共2096例样本。其中观察组采用银离子类敷料进行治疗,对照组采用不含银离子的其他类型敷料。Meta分析结果显示,银离子类敷料治疗组的CRWs痊愈率(OR=1.86,95%CI:1.30~2.66)和创面面积缩小率(MD=19.21%,95%CI:17.02~21.39)均高于对照组,而其平均换药次数(MD=-5.95,95%CI:-6.47~-5.44)、换药相关性疼痛评分(MD=-2.48,95%CI:-2.85~-2.11)、创面细菌阳性率(OR=0.16,95%CI:0.08~0.31,)和不良反应发生率(OR=0.37,95%CI:0.18~0.80)则均低于对照组。结论当前证据表明,与其他类型敷料相比,银离子类敷料可更好地促进慢性难愈性创面的愈合、缓解疼痛,且安全性好。展开更多
文摘Background:Hard-to-heal wounds are often compromised by the presence of biofilm.This presents an infection risk,yet traditional antimicrobial wound care products and systemic antibiotics are often used despite the uncertainty of therapeutic success and wound progression.The aim of this study was to investigate the clinical impact of a next-generation anti-biofilm Hydrofiber wound dressing(AQUACEL Ag+Extra[AQAg+E])in hard-to-heal wounds that had previously been treated unsuccessfully with traditional silver-,iodine-or polyhexamethylene biguanide(PHMB)-containing dressings and products and/or systemic antibiotics.Methods:Clinical case study evaluations of the anti-biofilm dressing were conducted,where deteriorating or stagnant wounds were selected by clinicians and primary dressings were replaced by the anti-biofilm dressing for up to 4 weeks,or as deemed clinically appropriate,with monitoring via case report forms.The data was stratified for cases where traditional silver-,iodine-or PHMBcontaining products,or systemic antibiotics,had been used prior to the introduction of the antibiofilm dressing.Results:Sixty-five cases were identified for inclusion,wounds ranging in duration from 1 week to 20 years(median:12 months).In 47(72%)cases the wounds were stagnant,while 15(23%)were deteriorating;3 wounds were not recorded.After an average of 4.2 weeks of management with the anti-biofilm dressing(range:1–11 weeks),in 11(17%)cases the wounds had healed(i.e.complete wound closure),40(62%)wounds improved,9(14%)wounds remained the same and 5(8%)wounds deteriorated.Conclusions:The introduction of this anti-biofilm dressing into protocols of care that had previously involved wound management with traditional antimicrobial products and/or antibiotics was shown to facilitate improvements in the healing status of most of these hard-to-heal wounds.Dressings containing proven anti-biofilm technology,in combination with antimicrobial silver and exudate management technology,appear to be an effective alternative to traditional anti
文摘目的系统评价银离子类敷料治疗慢性难愈性创面的促愈、减痛效果和安全性。方法计算机检索从建库至2022年9月6日PubMed、The Cochrane Library、Embase、Web of Science、中国知网、中国生物医学文献数据库、万方数据库及维普数据库中,关于银离子类敷料治疗慢性难愈性伤口的随机对照试验。经2名研究人员独立筛选文献、提取资料与评价文献质量后,应用Revman5.4软件行Meta分析。结果筛选后最终纳入21篇文献,共2096例样本。其中观察组采用银离子类敷料进行治疗,对照组采用不含银离子的其他类型敷料。Meta分析结果显示,银离子类敷料治疗组的CRWs痊愈率(OR=1.86,95%CI:1.30~2.66)和创面面积缩小率(MD=19.21%,95%CI:17.02~21.39)均高于对照组,而其平均换药次数(MD=-5.95,95%CI:-6.47~-5.44)、换药相关性疼痛评分(MD=-2.48,95%CI:-2.85~-2.11)、创面细菌阳性率(OR=0.16,95%CI:0.08~0.31,)和不良反应发生率(OR=0.37,95%CI:0.18~0.80)则均低于对照组。结论当前证据表明,与其他类型敷料相比,银离子类敷料可更好地促进慢性难愈性创面的愈合、缓解疼痛,且安全性好。
