Citation: | ZHANG Wei, ZENG Yan, TANG Yujia. Effect of polyhexamethylene biguanide antibacterial dressing in skin ulcers around the stoma in patients with enterostomy undergoing radiotherapy and chemotherapy[J]. Journal of Clinical Medicine in Practice, 2024, 28(7): 129-132,137. DOI: 10.7619/jcmp.20233928 |
To observe the application effect of polyhexamethylene biguanide (PHMB) antibacterial dressing in the treatment of skin ulcer around the stoma in patients with enterostomy during radiotherapy and chemotherapy.
A total of 65 patients with skin ulcer around the stoma during radiotherapy and chemotherapy were randomly divided into control group (34 cases) and observation group (31 cases). The control group was treated with silver ion dressing for skin ulcer around the stoma, while the observation group was treated with PHMB antibacterial dressing around the stoma. The healing rate of skin ulcer around the stoma, frequency of average dressing change, dressing cost at 4 weeks after treatment as well as Discoloration, Erosion, Tissue overgrowth (DET) score and ulcer status around the stoma were compared between the two groups at 2 and 4 weeks after treatment.
The healing rate of skin ulcer around the stoma in the observation group was (70.68±6.39)% at 4 weeks of treatment, which was higher than (57.76±12.82)% in the control group, and the dressing cost was less than that in the control group within 4 weeks (P < 0.05). There was no significant difference in the average dressing change frequency between the two groups within 4 weeks (P>0.05). At 2 and 4 weeks of treatment, the DET score and ulcer area around the stoma in the observation group were lower or smaller than those in the control group (P < 0.05).
The use of PHMB antibacterial dressing in the treatment of skin ulcer around the stoma in patients with enterostomy during radiotherapy and chemotherapy can effectively control infection, promote ulcer healing, and has excellent economic cost-effectiveness.
[1] |
胡爱玲, 郑美春, 李伟娟. 现代伤口与肠造口临床护理实践[M]. 2版. 北京: 中国协和医科大学出版社, 2018: 268-269.
|
[2] |
程珂, 曹希, 黎燕红, 等. 结直肠癌患者经济毒性的危险因素分析[J]. 中华肿瘤防治杂志, 2023, 30(16): 984-989. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL202316005.htm
|
[3] |
刘莺歌, 曹秋君, 吴燕. 肠造口周围皮肤并发症发生影响因素的系统评价[J]. 循证护理, 2020, 6(9): 894-904. https://www.cnki.com.cn/Article/CJFDTOTAL-XZHL202009005.htm
|
[4] |
PHATAK U R, KAO L S, YOU Y N, et al. Impact of ileostomy-related complications on the multidisciplinary treatment of rectal cancer[J]. Ann Surg Oncol, 2014, 21(2): 507-512. doi: 10.1245/s10434-013-3287-9
|
[5] |
宋琴芬, 刘春娥, 尹光啸, 等. 肠造口病人渗漏护理的研究进展[J]. 护理研究, 2020, 34(17): 3096-3098. doi: 10.12102/j.issn.1009-6493.2020.17.017
|
[6] |
姚泽欣, 程飚. 不同放化疗方案致放射性皮肤损伤的研究进展[J]. 医学研究生学报, 2020, 33(8): 861-866. https://www.cnki.com.cn/Article/CJFDTOTAL-JLYB202008017.htm
|
[7] |
徐文, 胡祥, 程海涛, 等. 聚六亚甲基双胍/甘油凝胶敷料通过清除细菌生物膜和增加Toll样受体2/4的表达以促进慢性创面愈合[J]. 中华实验外科杂志, 2023, 40(3): 515-519. doi: 10.3760/cma.j.cn421213-20220827-01263
|
[8] |
RIPPON M, ROGERS A A, WESTGATE S, et al. Effectiveness of a polyhexamethylene biguanide-containing wound cleansing solution using experimental biofilm models[J]. J Wound Care, 2023, 32(6): 359-367. doi: 10.12968/jowc.2023.32.6.359
|
[9] |
中华护理学会伤口造口失禁护理专业委员会. 成人肠造口护理标准[J]. 中华护理杂志, 2020, 55(2): 15-19. https://www.cnki.com.cn/Article/CJFDTOTAL-SHHL202106003.htm
|
[10] |
于娇, 金龙, 张高飞, 等. 全程营养支持治疗对局部晚期直肠癌新辅助同步放化疗患者营养状况、治疗耐受性和疗效的影响[J]. 实用肿瘤杂志, 2023, 38(2): 146-153. https://www.cnki.com.cn/Article/CJFDTOTAL-SYZZ202302008.htm
|
[11] |
刘涵予, 高琳琳, 陈华. 肠造口患者自我管理体验质性研究的Meta整合[J]. 中华现代护理杂志, 2023, 29(21): 2806-2813. https://www.cnki.com.cn/Article/CJFDTOTAL-XZHL202309004.htm
|
[12] |
HUANG Y B, SHI F L, WANG L M, et al. Preparation and evaluation of Bletilla striata polysaccharide/carboxymethyl chitosan/Carbomer 940 hydrogel for wound healing[J]. Int J Biol Macromol, 2019, 132: 729-737. doi: 10.1016/j.ijbiomac.2019.03.157
|
[13] |
李加敏, 庞冬, 张剑锋, 等. 造口周围皮肤评估工具的研究进展[J]. 护理研究, 2019, 33(24): 4267-4270. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201924016.htm
|
[14] |
TANEJA C, NETSCH D, ROLSTAD B S, et al. Risk and economic burden of peristomal skin complications following ostomy surgery[J]. J Wound Ostomy Continence Nurs, 2019, 46(2): 143-149. doi: 10.1097/WON.0000000000000509
|
[15] |
李婷, 张玲. 多学科协助式护理在肠造口周围脓肿患者经封闭式负压引流治疗中的应用[J]. 检验医学与临床, 2023, 20(17): 2586-2589. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202317029.htm
|
[16] |
周雪丹, 周海洋. 结直肠癌肠造口患者体力活动现状与影响因素分析[J]. 中华全科医学, 2021, 19(10): 1673-1676. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202110016.htm
|
[17] |
李可, 常素霞. 结直肠癌患者肠造口术后辅助化疗对造口并发症的影响[J]. 中国肛肠病杂志, 2023, 43(5): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-GCBZ202305013.htm
|
[18] |
王勉, 孙豪, 李一丁, 等. 类Altemeier术治疗肠造口脱垂6例的初步疗效观察[J]. 空军军医大学学报, 2024, 45(3): 337-340. https://www.cnki.com.cn/Article/CJFDTOTAL-DSJY202403016.htm
|
[19] |
刘小平, 姜萍, 童辉群, 等. 以自我效能为核心的护理路径对胃肠肿瘤术后肠造口患者生活质量的影响[J]. 检验医学与临床, 2022, 19(24): 3434-3437. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202224032.htm
|
[20] |
董炜, 肖玉瑞, 吴敏洁, 等. 中国慢性难愈性创面诊疗思路及原则[J]. 中华烧伤杂志, 2018, 34(12): 868-873.
|
[21] |
SOWLATI-HASHJIN S, CARBONE P, KARTTUNEN M. Insights into the polyhexamethylene biguanide (PHMB) mechanism of action on bacterial membrane and DNA: a molecular dynamics study[J]. J Phys Chem B, 2020, 124(22): 4487-4497.
|
[22] |
周凌寒, 康丽萍, 康良琦, 等. 银离子敷料联合负压引流治疗感染性伤口的系统评价[J]. 中华护理教育, 2021, 18(11): 1032-1039. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHU202111017.htm
|
[23] |
吴斌, 李荣. VSD联合银离子敷料治疗慢性创面的疗效观察及护理探讨[J]. 中国美容医学, 2023, 32(2): 64-67. https://www.cnki.com.cn/Article/CJFDTOTAL-MRYX202302012.htm
|
[24] |
郑洪伶, 蒋璐, 苏琼. 国际伤口感染研究所2022版《临床实践中的感染伤口——最佳实践原则》中伤口感染风险评估、识别和诊断内容解读[J]. 护理研究, 2023, 37(15): 2665-2672. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202315001.htm
|
[25] |
COOPER D M, BOJKE C, GHOSH P. Cost-Effectiveness of PHMB & betaine wound bed preparation compared with standard care in venous leg ulcers: a cost-utility analysis in the United Kingdom[J]. J Tissue Viability, 2023, 32(2): 262-269.
|