两种银敷料对慢性伤口愈合及渗液酸碱度影响的比较

目的比较两种银敷料辅助治疗慢性感染伤口的效果及对伤口渗液酸碱度的影响,以指导银敷料在慢性伤口治疗中的合理使用。方法将糖尿病足溃疡、压疮、下肢静脉溃疡、创伤性溃疡、烧伤残余创面5类慢性伤口患者104例随机分为A、B两组,每组52例。两组患者均按照统一方法评估、清洗和清创后,A组使用银离子藻酸盐敷料、B组使用纳米银敷料,分别接受30d的伤口局部辅助治疗。观察比较两组伤口治疗前及治疗后不同时间段的伤口愈合评分及渗液pH值。结果随着治疗时间的延长,两组伤口愈合计分和渗液pH值均较治疗前下降,A组患者伤口愈合计分显著优于B组(P0.01);两组伤口渗液pH值比较,差异无统计学意义(P0.05)。结论两种银敷料辅助治疗慢性感染伤口均能促进伤口愈合,但银离子藻酸盐敷料的效果更优;两种银敷料均能降低伤口渗液pH值且作用相当。

Comparison of the effects of two types of silver-containing dressing on wound healing and pH of wound fluids in chronic wound infection

Objective To compare the effects of two types of silver-containing dressing in treatment of chronic wound infection and to monitor pH of wound fluids during the treatment,so as to provide information for reasonable use of silver dressing.Methods A to tal of 104 patients with diabetic foot ulceration,pressure ulcer,venous leg ulceration,traumatic ulceration,or unhealed burn wounds were randomized into two groups of 52.After standardized assessment,cleansing and debridement,Group A received silver-alginate-containing dressing and Group B received nanocrystalline silver dressing for 30 days of adjuvant therapy.Wound healing,which was measured using the Pressure Ulcer Scale for Healing (PUSH),and pH of wound fluids were measured before and at different time points during the treatment.Results The PUSH score and pH of wound fluids were decreased as time went on.The PUSH score in the Group A was significantly lower than the Group B (P＜0.01),whereas the pH of wound fluids had no significant difference between the two groups (P＞0.05).Conclusion Either silve alginate containing dressing or nanocrystalline silver dressing facilitates wound healing,but silver-alginate containing dressing is more effective.The two silver-containing dressings have equivalent effectiveness in decreasing wound pH.