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BACKGROUND: Red light irradiation and silver ion dressing are mostly used to treat chronic difficult healing wounds clinically, but the optimal irradiation time of red light irradiation and silver ion dressing for chronic non-healing wounds, and the combination of different silver ion dressings have not been determined. OBJECTIVE: To investigate the optimal irradiation time and dressing combination of red light and silver ion dressing in the therapy of chronic non-healing wounds. METHODS: The chronic non-healing wound model was made by applying Staphylococcus aureus on the whole skin defect and subcutaneous hydrocortisone injection in SD rats. 72 rat models were randomly divided into 4 groups with 18 rats in each group by random number table method. The rats were treated on the basis of standard dressing change and the following therapy: A1B1 group (red irradiation 20 minutes + lipid hydrocolloidal silver sulfate dressing), A1B2 group (red light irradiation 20 minutes + calcium alginate fiber dressing), A2B1 group (red light irradiation 30 minutes + lipid hydrocolloidal silver sulfate dressing), and A2B2 group (red light irradiation 30 minutes + calcium alginate fiber dressing); change dressing, irradiate once, and change dressing every 24 hours. After 14 days of continuous treatment, wound healing rate, bacterial colony number, inflammatory response, histomorphology and angiogenesis were detected in each group. RESULTS AND CONCLUSION: (1) With the extension of treatment time, the wound healing rate of rats in the four groups was increased, and the wound healing rate of rats in the A2B2 group at 3, 7, and 14 days after treatment was higher than that in the other three groups (P < 0.05). (2) The wound bacterial culture results on day 7 after treatment demonstrated that the number of bacterial colonies in the A2B2 group was lower than that in the other three groups (P < 0.05). Western blot assay exhibited that with the extension of treatment time, the protein expressions of tumor necrosis factor α and interleukin-6 in wound tissue of rats in the four groups were decreased, while the protein expressions of interleukin-10 were increased. The protein expressions of tumor necrosis factor α and interleukin-6 in the A2B2 group were lower than those in the other three groups (P < 0.05). The protein expression of interleukin-10 in the A2B2 group was higher than that of the other three groups (P < 0.05). (3) The wound hematoxylin-eosin staining on day 14 after treatment demonstrated that a large number of collagen fibers in the A2B2 group were parallel distributed and the most closely connected, which was significantly better than the other three groups. (4) The results of immunofluorescence staining indicated that the fluorescence intensity expression of CD31 in the A2B2 group was higher than that in the A1B1, A1B2 and A2B1 groups (P < 0.05). q-PCR detection at 3, 7, and 14 days after treatment exhibited that the mRNA expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups (P < 0.05). Western blot assay at 3, 7 and 14 days after treatment revealed that the protein expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups (P < 0.05). (5) These findings confirm that 30 minutes of red light irradiation combined with silver alginate fiber dressing has better results in treatment of chronic non-healing wounds. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect and safety of Chinese herbal medicine Shuanghuangdan dressing combined with silver ion dressing change in improving the healing of diabetic foot wounds. Methods Totally 45 patients with diabetic foot wounds were randomly divided into three groups: Shuanghuangdan group (n=15), silver ion group(n=15) and combined treatment group (n=15). Based on the symptomatic treatment, dressing change with different dressing materials was performed. The Traditional Chinese Medicine (TCM) syndrome integral and wound healing condition were evaluated and compared between three groups. Results The combined treatment group demonstrated the smallest wound remaining after a four-week intervention, and there was a significant different between combined treatment group and Shuanghuangdan group in wound remaining(P＜0. 05). The VEGF level in the combined treatment group was higher than that in the Shuanghuangdan group and silver ion group, respectively (P＜0. 05). The TCM syndrome integral in the combined treatment group was lower than that in the Shuanghuangdan group and silver ion group, respectively (P＜0. 05). Conclusion By promoting growth of granulation tissue and blood capillary, Chinese herbal medicine dressing combined with silver ion dressing change shows a positive effect in relief of inflammation and healing of diabetic foot wounds. It is a safe and effective treatment for patients with diabetic foot wounds (目的 观察中药制剂双黄丹敷料、银离子敷料联合换药促进糖尿病足创面愈合的临床疗效, 评价其有效性和安全性。方法 选择2021年3月—9月在贵州中医药大学第一附属医院就诊的糖尿病足患者45例, 按随机数字表法分组分为双黄丹组、银离子组和双黄丹联合银离子组(联合组), 各15例。在常规对症治疗的基础上, 三组分别给予自制中药双黄丹敷料换药、银离子敷料换药和中药双黄丹联合银离子敷料换药。比较三组中医证候积分, 评估创面愈合情况。结果 治疗后, 联合治疗组创面面积最低, 与双黄丹组比较, 差异有统计学意义(P＜0. 05)。VEGF水平联合治疗组高于双黄丹组和银离子组, 中医证候积分联合治疗组低于双黄丹组和银离子组, 差异有统计学意义(P＜0. 05)。结论 中药制剂双黄丹敷料联合银离子敷料换药能明显减轻患者的炎症反应, 促进肉芽组织和新生毛细血管生长, 促进伤口创面愈合, 且创面愈合效果明显优于单纯双黄丹敷料或银离子敷料换药。)

This paper summarized the experience of wound care for a patient with diabetic foot of Wagner grade 3. Based on the clinical evaluation of illness condition and risk assessment, targeted nursing interventions on wound dressing, pain control, nutrition support and psychological care were carried out, in order to improve the recovery of diabetic foot ulcers. (本文总结1例Wagner 3级糖尿病足患者的伤口护理经验, 通过科学评估, 了解患者整体情况, 明确风险因素, 以此制定针对性的伤口换药、疼痛干预、营养支持以及心理干预方案, 帮助患者树立治疗信心, 促进患者伤口恢复。)

Objective To investigate the clinical efficacy of silver ion dressing in the treatment of chronic wounds in diabetic patients. Methods A retrospective analysis of 60 diabetic patients with chronic refractory wounds admitted to our hospital and cooperative units between February 2018 and February 2019 was conducted. The patients were divided into the experimental group (silver ion dressing group) and the control group (silver sulfadiazine group) according to the wound treatment. According to the Bates-Jensen Wound Assessment Tool (BWAT), the wound healing, infection and healing time of the two groups were scored and compared. Statistical analysis was performed using Mann-Whitney U test, independent sample t test and χ2 and Fisher exact test. Results (1) Wound situation. There was no significant difference in the BWAT scores of the two groups on the 7th and 14th days; on the 21st day, the BWAT score of the silver ion dressing group was significantly lower than that of the silver sulfadiazine group (P<0.05). However, there was no significant difference in the BWAT% scores of the two groups on the 7th day; on the 14th and 21st days, the BWAT% score of the silver ion dressing group was significantly lower than that of the silver sulfadiazine group (P<0.05). (2) Wound infection status. The BWAT-I scores of the two groups on the 1st and 7th days were significantly different (P<0.05), and the silver ion dressing group was higher than the silver sulfadiazine group; there was no significant difference in the BWAT-I scores of the two groups on the 14th and the 21st days. There were significant differences in the BWAT-I% between the two groups on the 7th, 14th and 21st days (P<0.05). The silver ion dressing group was significantly lower than the silver sulfadiazine group. (3) Wound healing time. The wound healing time of the silver ion dressing group [34.50 (22.75, 57.25) d] was significantly shorter than that of the silver sulfadiazine group [46.50 (37.75, 64.75) d], and the difference was statistically significant (Z=-2.191, P<0.05). Conclusion On the basis of thorough debridement, the topical application of silver ion dressing on chronic wounds in diabetic patients can effectively reduce and control wound infections and speed up the process of wound repair. [ABSTRACT FROM AUTHOR]

BACKGROUND: Silver dressings have good anti-infective effect, but there is still a lack of evidence from randomized controlled studies on the efficacy of silver dressings in the treatment of chronic infected wounds. OBJECTIVE: To systematically evaluate the efficacy of silver dressings in the treatment of chronic infected wounds. METHODS: Databases of PubMed, Cochrane Library, EMbase, Web of science, CNKI, CBM, WanFang and Baidu Scholar were searched for the randomized controlled trials reporting the efficacy of silver dressings on chronic infected wounds published before August 2018. Literature screening, data extraction and quality assessment were conducted by two researchers, and a meta-analysis was performed on RevMan 5.3 software. RESULTS AND CONCLUSION: Nine randomized controlled trials including 1 268 patients were enrolled. The trial group was treated with silver dressings, and the control group was treated with dialginate dressings, conventional dressings, foam dressings, general dressings, sterile gauze, vaseline gauze, sterilized gauze or povidone iodine gauze. The meta-analysis results showed that compared with the control group, the wound healing rate in the trial group was increased [OR=4.53, 95%CI (2.87, 7.15), P < 0.000 01], the rate of wound area reduction was increased [MD=8.90, 95%CI (2.05, 15.76), P=0.01], the times of dressing change was decreased [MD=-8.91, 95%CI (-14.33, -3.48), P=0.001], and the debridement time was shortened [MD=-8.92, 95%CI (-10.03, -7.81), P < 0.000 01]. To conclude, silver dressings can promote healing of chronic infected wounds. [ABSTRACT FROM AUTHOR]

BACKGROUND: Various kinds of dressings for diabetic foot have been developed, among which, silver dressing has been widely used, but no conclusion has been reached yet. OBJECTIVE: To evaluate the effects of silver dressing in the treatment of diabetic foot ulcers by a Meta-analysis. METHODS: A systematic search of literatures in PubMed, Embase, Elsevier, CNKI, CBM, VIP and WanFang from inception to March 2018 was conducted. The quality of the literatures was appraised and data were extracted by two researchers independently. Meta-analysis was then conducted for the included literatures. RESULTS AND CONCLUSION: A total of 7 randomized controlled trials involving 642 patients were included. The meta-analysis results showed that the wound healing rate of silver dressing group was significantly higher than that of the other dressing groups [odds ratio (OR)=2.34, 95% confidence interval (CI) (1.57, 3.48), P < 0.000 1], epithelial formation time was significantly shorter than that of other dressing groups [mean difference (MD)=-2.22, 95% CI (-2.77, -1.66), P < 0.000 01], occurrence time of granulation tissue was significantly shorter than that of the other dressing groups[MD=-2.84, 95% CI (-3.26, -2.41), P < 0.000 01], wound healing time was significantly shorter than that of the other dressing groups [MD=-11.13, 95% CI (-19.87, -2.39), P=0.01]. Overall, silver dressing can promote the healing of diabetic foot ulcers. [ABSTRACT FROM AUTHOR]