濕式傷口護理法的機轉原理
經過醫療研究發現,親水性水膠體敷料(Hydrocolloid Dressing)可以維持傷口溫潤環境,促進傷口癒合速度並不易留下疤痕。經研究證實,透過使用親水性水膠體敷料,吸收過多的組織液,並讓傷口維持在一個溫潤的環境下,細胞會加速修補傷口組織,清理傷口的殘留物,並促進新皮膚的生成(註1)並且不易結痂,也就不易留下疤痕(註2)。並且神經末梢會被保護,大幅降低疼痛(註3)。
而傳統的乾式傷口護理法(如:使用一般傳統紗布OK繃),因為會讓傷口過於乾燥導致結痂,而和跟一般人認知的不同是,結痂反而容易阻礙細胞修復組織,讓恢復速度變慢,並且容易造成二次傷口傷害或是造成細菌特別容易攻擊該處造成發炎感染,也容易因此留下疤痕。
臨床參考文獻
1. 濕式傷口護理:促進傷口更快癒合
• Harding, K. Cutting K, Price P. The cost effectiveness of wound management protocols o care. British J Nursing 2000; (Suppl) 9(19: S6, S8, S10 passim
• Kerstein MD, Gemmen E, vanRijswijk L, Lyder CH, Phillips T, Xakellis G, Golden K, Harrington C. Cost and cost effectiveness of venous and pressure ulcer protocols of care. Disease Management and Health Outcomes, 2001, 9(11):651-663.
• Meaume S, Gemmen E. Cost-effectiveness of wound management in France: pressure ulcers and venous leg ulcers. J Wound Care. 2002;11(6):219-24.
• Bouza C, Saz Z, Muñoz A, Amate JM. Efficacy of advanced dressings in the treatment of pressure ulcers: a systematic review. J Wound Care. 2005;14(5):193-9.
• Cullum N, Petherick E. Pressure ulcers. BMJ Clinical Evidence, Web publication date November 01,2006, at clinicalevidence.bmj.com, accessed February 1, 2008.
• de Laat EH, Scholte op Reimer WJ, van Achterberg T. Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature. J Clin Nurs. 2005 Apr;14(4):464-72.
• Bolton l, McNees P, van Rijswijk L, de Leon J, Lyder C, Kobza L, Edman K, Scheurich A, Shannon R, Toth M, and the Wound Outcomes Study Group. Wound-healing outcomes using standardized assessment and care in clinical practice. JWOCN 2004; 31(2): 65-71.
• O’Donnell TF Jr., Lau J. A systematic review of randomized controlled trials of wound dressings for chronic venous ulcer. J Vasc Surg. 2006;44(5):1118-25.
• Romanelli, M. Objective measurement of venous ulcer debridement and granulation with a skin color reflectance analyzer. Wounds 1997; 9(4): 122-126.
• Mulder G, Jones R, Cederholm Williams S, Cherry G, RyanT. Fibrin cuff lysis in chronic venous ulcers treated with a hydrocolloid dressing. International J Dermatology 1993;32(4):304 306.
• Gallego EA, Peris CC, Diez-Garcia MT, Mendoza G, Nũňez-Fernandez JM, Rios JP. Therapeutic behavior of a hydrocolloid dressing. Its evolution in the treatment of acute and chronic dermal ulcers. Revista de ROL Enfermeria, 2005;28(12):841-847.
• Steenfos et al., Comparison of Sureskin, Duoderm E and Jelonet Gauze in split skin donor sites – a clinical and histological evaluation. Journal of European Academy of Dermatology and Venereology
• Hermans, M.E. Hydrocolloid dressings versus tulle gauze in the treatment of abrasions in cyclists. International J of Sports Medicine 1991;12(6):581 584.
2. 親水性敷料:幫助降低疤痕生成機率
• Michie, D.D., Hugill, J.V. Influence of occlusive and impregnated gauze dressings on incisional healing: A prospective, randomized, controlled study. Annals of Plastic Surgery 1994;32:57-64.
• Phillips T, Gerstein AD, Lordan V. A randomized controlled trial of hydrocolloid dressing in the treatment of hypertrophic scars and keloids. Dermatol Surg 1996;22:775-778.
3. 親水性敷料人工皮:幫助降低疼痛、摩擦和不舒適感
• Nemeth A, Eaglstein WH, Taylor JR, Peerson LJ, Falanga V. Faster healing and less pain in skin biopsy sites treated with an occlusive dressing. Archives of Dermatology 1991;127:1679 1683.
• Wiechula R. The use of moist wound-healing dressings in the management of split-thickness skin graft donor sites: a systematic review. Int J Nurs Pract. 2003; 9:S9-S17.
• Wyatt D, McGowan DN, Najarian MP. Comparison of a hydrocolloid dressing and silver sulfadiazine cream in the outpatient management of second-degree burns. The Journal of Trauma 1990;30(7):857-865.
• Arnold, T.E., Stanley, J.C. Fellows EP, Moncada GA, Allen R, Hutchinson JJ, Swartz WM, Bolton LL, Vickers CFH, Kerstein MD. Prospective, multicenter study of managing lower extremity venous ulcers. Annals of Vascular Surgery 1994;8(4):356 362.
• Lindholm C. Leg ulcer treatment in hospital and primary care in Sweden: Cost effective care and quality of life. Proceedings of the International Committee on Wound Management Meeting. Adv Wound Care1995;8:42-47.
• Ohlsson, P., Larsson, K., Lindholm, C., Moller, M. A cost effectiveness study of leg ulcer treatment in primary care, comparison of saline gauze and hydrocolloid treatment in a prospective, randomized study. Scand J Prim Health Care 1994;12:295-299.
• Petersen LJ, Beck J, Reumert LN, Steensgaard J. Hydrocolloid occlusion for the treatment of neurovascular corns. J Am Podiatr Med Assoc. 1991;81(12):643-6.
• Greguric S, Budimicic, Soldo-Belic A, Tudoric M, Baricevic B, Cajkovac V, Dobric I. Hydrocolloid dressing versus a conventional dressing using magnesium sulphate paste in the management of venous leg ulcers. Acta Dermatovenerol. Croat. 1994;2(2):65-71