Abstract:
Diabetic foot ulcers (DFUs) are a prevalent complication of diabetes mellitus and are associated with significant morbidity and mortality. The essential role of oxygen in the treatment of DFUs is documented. Indicated for use on a variety of wound types, topical haemoglobin therapy (Granulox®) is a novel therapeutic technology that binds atmospheric oxygen and improves the availability of oxygen at the wound site. When used as part of the wound management strategy, this therapy helps to reduce inflammation, exudate and slough, and promotes wound healing. In South Africa, health resources, coordinated foot care and podiatry, and data on diabetic foot complications are limited. Twelve patient case studies assessing the impact of adding topical haemoglobin therapy to the management regimes for DFUs and surgical (post-amputation) wounds were undertaken in South Africa. Patients were aged 50-71 years, and all had diabetes mellitus. At baseline, the area of the wounds ranged from 10.2 to 149.6 cm2 with depths ranging from 0.2 to 0.9 cm. Clinical signs of wound infection and high levels of viscous exudate were recorded in all cases. Wound dressings were changed twice weekly and sharp debridement of the wound performed as necessary. The wounds were cleansed and then completely coated with a thin film of Granulox® and dressings applied. Treatment was monitored over periods ranging from 57 to 276 days, during which dressings were changed and Granulox® administered to the wounds, ranging from 16 to 79 times. During the period of evaluation, wound size steadily reduced (by 87.1-100%), the condition of the wound bed tissue and peri-wound skin improved, and clinical signs of wound infection steadily resolved. Wounds significantly improved in two patients, almost healed in six patients, and healed in four patients. All patients reported a reduction in malodour and pain; seven patients were pain-free at the final followup assessment. The overall impression of Granulox® was rated as \'very good\' by the clinicians, who considered that Granulox® facilitated an increase in tissue viability, with the promotion of granulation tissue, and stimulated epithelialisation.
摘要:
糖尿病足溃疡(DFU)是糖尿病的常见并发症,并且与显著的发病率和死亡率相关。记录了氧气在DFU治疗中的重要作用。指示用于各种伤口类型,局部血红蛋白疗法(Granulox®)是一种新型的治疗技术,其结合大气中的氧气并提高伤口部位的氧气利用率。当用作伤口管理策略的一部分时,这种疗法有助于减少炎症,渗出物和淤泥,促进伤口愈合.在南非,卫生资源,协调足部护理和足疗,关于糖尿病足并发症的数据有限。在南非进行了十二个患者案例研究,评估了在DFU和手术(截肢后)伤口的治疗方案中添加局部血红蛋白疗法的影响。患者年龄50-71岁,都有糖尿病.在基线,伤口面积为10.2至149.6cm2,深度为0.2至0.9cm。在所有病例中都记录了伤口感染的临床体征和高水平的粘性渗出物。每周两次更换伤口敷料,并根据需要进行伤口的锐利清创。清洁伤口,然后用Granulox®薄膜完全涂覆并施加敷料。在57至276天的时间段内监测治疗,在此期间更换敷料并对伤口施用Granulox®,从16到79倍不等。在评估期间,伤口大小稳步减少(87.1-100%),伤口床组织和伤口周围皮肤的状况得到改善,伤口感染的临床症状稳步缓解。两名患者的伤口明显改善,六个病人几乎痊愈了,四个病人都痊愈了.所有患者均报告恶臭和疼痛减少;最终随访评估中有7名患者无痛。Granulox®的总体印象被临床医生评为“非常好”,他认为Granulox®促进了组织活力的增加,随着肉芽组织的促进,和刺激的上皮化。