探討活性碳銀離子敷料對感染性壓傷治療之成效

The Effectiveness of Activated Carbon Silver Ion Dressings for Treatment of Infected Pressure Injury

目的：壓傷是最應被重視的疾病，其合併傷口感染時將會延長照護，臨床發現活性碳銀離子敷料可使微生物菌種感染下降與降低換藥時疼痛，但無研究證明，因此進一步探討活性碳銀離子敷料對於感染性壓傷之成效。方法：本研究為類實驗性研究，採立意取樣，收案期間自2015年5月22日至2016年5月21日，共收案68個傷口，由專科護理師評估活性碳銀離子敷料與銀離子藻膠敷料在傷口疼痛指數、傷口面積、微生物菌種感染與傷口床之差異。結果：運用SPSS套裝軟體分析下，活性碳銀離子敷料能降低傷口疼痛及傷口床總分(p<0.001)，但在微生物菌種感染數與傷口面積皆無顯著差異(p>0.05)。然而，活性碳銀離子敷料與銀離子藻膠敷料無比較上的差異(p>0.05)。結論：利用活性碳銀離子敷料，能降低傷口疼痛指數與傷口床分數，但是本研究受限於時間及人力，可能會有引介偏差(referral bias)存在。除此之外，本研究僅為前驅性研究(pilot study)，期盼未來能有較大規模之研究探討其差異性。

Objectives. Pressure injuries are frequently encountered in healthcare and increase the number of hospitalization days. Thus, modern dressings, especially those that decrease the drug-resistant infection rates, antibiotics dosage, and pain during dressing changes, are becoming more popular. In this study, we explored the effectiveness of two activated carbon silver dressings on infected wound healing using a conceptual model of wound bed preparation.
Methods. In this quasi-experimental study, we sampled 68 wounds in 60 persons from May 22, 2015 to May 21, 2016. Surgical dressings were changed every three days after admission by a single researcher. Wounds were evaluated on the 1st, 4th, 7th, and 14th day after surgical procedures. All statistical operations were performed using SPSS 20.0.
Results. Use of activated carbon silver dressing reduced the wound pain and wound bed scores (p<0.001), but we found no significant difference in decreases in infection rate and wound healing area (cm2)(p<0.05).
Conclusion. We found no significant difference in changes in wound area and dressing (p>0.05 ). Both wound dressings were sliver dressings and we did not compare them with other dressings without silver. Further studies with larger sample sizes and different designs to further explore the differences in dressings.