Debridement for surgical wounds

被引:24
作者
Dryburgh, Nancy [1 ]
Smith, Fiona [1 ]
Donaldson, Jayne [1 ]
Mitchell, Melloney [2 ]
机构
[1] Napier Univ, Sch Nursing Midwifery & Social Care, Edinburgh EH9 2TB, Midlothian, Scotland
[2] Royal Infirm, Edinburgh, Midlothian, Scotland
来源
COCHRANE DATABASE OF SYSTEMATIC REVIEWS | 2008年 / 03期
关键词
D O I
10.1002/14651858.CD006214.pub2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. Objectives The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. Search strategy We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register ( searched 3/3/08), Cochrane Central Register of Controlled Trials ( CENTRAL) ( the Cochrane Library, 2008, issue 1), MEDLINE ( 1950 to February Week 3 2008), EMBASE ( 1980 to 2008 Week 09) and CINHAL ( 1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. Selection criteria We included relevant randomised controlled trials ( RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Data collection and analysis Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Main results Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed ( complete debridement). One trial compared an enzymatic agent (Streptokinase/ streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products ( different comparator in each trial) to achieve complete debridement. Meta analysis was not possible due to the unique comparisons within each trial. One trial reported that dextranomer achieved a clean wound bed significantly more quickly than Eusol, and one trial comparing enzymatic debridement with saline-soaked dressings reported that the enzyme treated wounds were cleaned more quickly. However methodological quality was poor in these two trials. Authors' conclusions There is a lack of large, high quality published RCTs evaluating debridement p e r s e or comparing different methods of debridement for surgical wounds, to guide clinical decision making.
引用
收藏
页数:29
相关论文
共 67 条
[1]   Novel treatment strategy for leg and sternal wound complications after coronary artery bypass graft surgery: Bioengineered Apligraf [J].
Allie, DE ;
Hebert, CJ ;
Lirtzman, MD ;
Wyatt, CH ;
Keller, VA ;
Souther, SM ;
Allie, AA ;
Mitran, EV ;
Walker, CM .
ANNALS OF THORACIC SURGERY, 2004, 78 (02) :673-678
[2]  
[Anonymous], WOUND CARE NURSING P
[3]  
[Anonymous], 1994, CARE WOUNDS
[4]  
[Anonymous], J COMMUNITY NURSING
[5]  
[Anonymous], BRIT J COMMUNITY NUR
[6]  
[Anonymous], FORMULARY WOUND MANA
[7]  
[Anonymous], 1999, CLIN RELEVANCE DEBRI
[8]  
[Anonymous], B EKSPERIMENTALNOI B
[9]  
[Anonymous], RAPID SYSTEMATIC REV
[10]  
[Anonymous], KHIRURGIIA MOSKVA