两种皮肤保护方法在负压治疗慢性伤口中的应用研究

目的 探索两种皮肤保护方法对预防负压伤口治疗相关的潮湿相关性皮肤损伤的效果。方法 纳入具有负压伤口治疗适应证的慢性伤口患者132例,随机分为两组,每组各66例。试验组采用防漏膏封堵伤口周围皮肤保护法,对照组采用多聚合物无痛皮肤保护膜涂抹法,两组均干预14 d后,使用标准的湿性治疗随访至愈合或3个月。评价指标：负压治疗期间伤口周围皮肤潮湿相关性皮肤损伤发生率为主要结局指标,负压治疗过程中的漏气报警和皮肤浸渍频次、伤口面积、深度缩小率及随访3个月末的伤口治愈率与愈合时间为次要结局指标。结果 共脱落6例,试验组在负压治疗期间潮湿相关性皮肤损伤发生率、漏气报警和皮肤浸渍频次均少于对照组（均P<0.05）。试验组负压治疗14 d的伤口面积缩小率大于对照组（P<0.05）,深度缩小率两组接近（P>0.05）。随访期末试验组治愈率高于对照组（P<0.05）,两组愈合时间接近（P>0.05）。结论 两种皮肤保护法对预防潮湿相关性皮肤损伤均有一定效果,防漏膏保护法效果更优,在确保负压治疗顺利进行,改善伤口治疗效果,促进伤口愈合中发挥重要作用,适用于不同类型、不同部位的慢性伤口患者。

Comparative study of two methods of protecting skin for patients with chronic wounds treated by negative pressure wound therapy

Objective To explore the effect of two skin protecting methods in negative pressure wound therapy(NPWT)for chronic wounds in order to prevent NPWT-related moisture-associated skin damage(MASD).Methods A total of 132 patients with chronic wounds were enrolled and randomly divided into two groups,66 cases in each group.During NPWT,the intervention group used a leak-proof paste for protecting peri-wound skin,and the control group was applied with a multi-polymer free pain skin protective dressing for protecting peri-wound skin.Both groups were treated for 14 days and then followed up with standard moisture therapy until healed or 3 months.Primary outcome:incidence of MASD around wound during NPWT;secondary outcomes:frequency of leakage alarm,skin impregnation frequency,the reduction rate of wound area,depth during NPWT,and rate of wound healing,and healing time during the follow-up.Results A total of 6 cases were dropped.In the full analysis set,the MASD incidence,the frequency of leakage alarm and skin impregnation in the intervention group were less than those in the control group(P<0.05).The difference in the reduction rate of wound area between the two groups was significant(P<0.05).The difference in the depth reduction rate between the two groups was no significance(P>0.05).At the end of the follow-up period,the rate of wound healing in the intervention group was higher than that in the control group(P<0.05),and healing time of both groups was close(P>0.05).Conclusion The research proved that two protecting skin methods had some effects on protect peri-wound skin and preventing NPWT-related MASD.The leakproof paste method was better and it played an important role in ensuring NPWT,improving wound treatment outcomes and promoting wound healing and it is suitable for patients with different types and locations of chronic wounds.