纺织学报 ›› 2020, Vol. 41 ›› Issue (09): 183-190.doi: 10.13475/j.fzxb.20191205108

• 专栏:生物医用纺织材料及其制品 • 上一篇    下一篇

含银海藻酸盐医用敷料的临床应用

秦益民1,2()   

  1. 1.嘉兴学院 材料与纺织工程学院, 浙江 嘉兴 314001
    2.海藻活性物质国家重点实验室, 山东 青岛 266400
  • 收稿日期:2019-12-23 修回日期:2020-05-26 出版日期:2020-09-15 发布日期:2020-09-25
  • 作者简介:秦益民(1965—),男,教授,博士。主要研究方向为功能性纤维。E-mail: yiminqin1965@126.com
  • 基金资助:
    国家重点研发计划项目(2018YFC1105600)

Clinical applications of silver containing alginate wound dressings

QIN Yimin1,2()   

  1. 1. College of Material and Textile Engineering, Jiaxing University, Jiaxing, Zhejiang 314001, China
    2. State Key Laboratory of Bioactive Seaweed Substances, Qingdao, Shandong 266400, China
  • Received:2019-12-23 Revised:2020-05-26 Online:2020-09-15 Published:2020-09-25

摘要:

为促进含银海藻酸盐纤维在医疗卫生领域的应用,开发具有高吸湿、强抗菌性的功能性医用敷料,介绍了国际市场上含银海藻酸盐纤维和医用敷料的主要品种、制备方法、产品性能及其应用领域;总结了含银海藻酸盐纤维和医用敷料在慢性伤口护理中控制创面感染增加细菌转阴率、抑制细菌增长减轻患者疼痛、促进伤口愈合缩短治疗周期以及降低治疗费用等方面的优良使用功效;总结了合理使用含银医用敷料过程中需要考虑的因素。结合全球各地的最新临床应用研究成果指出:含银海藻酸盐医用敷料在感染伤口、烧伤创面、手术切口、糖尿病足溃疡伤口、下肢静脉溃疡、压疮等创面护理中的应用价值。

关键词: 海藻酸盐纤维, 医用敷料, 生物医用材料, 银离子, 抗菌性能

Abstract:

In order to promote the applications of silver containing alginate fibers and develop functional wound dressings with high absorbency and strong antimicrobial properties, this paper introduced the main varieties, production methods, product properties and applications of silver containing fibers and wound dressings in the international market, and summarized their efficacy in reducing the re-infection ratio through control of wound infection, relieving pain through suppression of bacteria growth, shortening treatment cycle through the promotion of healing and reducing the treatment cost and other outstanding benefits. Combining the latest clinical research results from around the world, this paper outlined the clinical values of silver containing alginate fibers and wound dressings in the management of infected wound, burn wound, clinical incision, diabetic foot ulcer, leg ulcer, pressure sore and other types of wounds.

Key words: alginate fiber, wound dressing, biomedical material, silver ion, antimicrobial property

中图分类号: 

  • TS131.9

表1

国际市场上主要的含银海藻酸盐医用敷料"

产品名称 制造商 基础材料 银化合物
Acticoat Absorbent Smith & Nephew 海藻酸盐纤维复合聚乙烯膜 纳米银
Algicell Ag Derma Sciences 海藻酸钙纤维 银离子
Algidex Ag DeRoyal 海藻酸钙纤维复合泡绵 银离子
Algisite Ag Smith & Nephew 海藻酸钙纤维 银离子
Askina Calgitrol Ag B. Braun 海藻酸钙纤维复合泡绵 银离子
Invacare Silver Alginate Invacare 海藻酸盐与CMC共混纤维 磷酸锆钠银
Maxorb Extra Ag Medline 海藻酸盐与CMC共混纤维 磷酸锆钠银
Melgisorb Ag M?lnlycke 海藻酸盐与CMC共混纤维 磷酸锆钠银
Restore Calcium Alginate Hollister Woundcare 海藻酸钙纤维 银离子
SeaSorb Ag Coloplast 海藻酸盐与CMC共混纤维 磷酸锆钠银
Silvercel & Silvercel Non Adherent Systagenix 海藻酸盐与CMC共混纤维复合不粘层 镀银锦纶纤维
Silverlon Calcium Alginate Argentum Medical 海藻酸钙纤维 镀银锦纶纤维核心层
Tegaderm Alginate Ag 3 M 海藻酸盐与CMC共混纤维 磷酸锆钠银
UrgoSorb Silver Urgo 海藻酸盐与CMC共混纤维 磷酸锆钠银

图1

含银海藻酸盐纤维医用敷料的作用机制"

表2

患者伤口细菌转阴率的比较"

组别 例数 伤口细菌转阴例数
治疗7 d后 治疗14 d后 治疗21 d后
观察组 62 19 28 56
对照组 62 11 20 39

表3

二组患者换药时的疼痛评分比较"

组别 疼痛评分
换药前 换药后3 d 换药后7 d 换药后15 d
观察组 5.47±1.22 3.08±0.54 2.66±0.53 1.96±0.41
对照组 5.89±1.54 5.53±0.68 4.88±0.75 2.12±0.72

表4

伤口换药时间及创面愈合时间比较"

组别 例数 换药时间/d 创面愈合时间/d
观察组 40 7.69±2.19 10.57±4.38
对照组 40 13.57±3.48 17.58±4.50

表5

患者伤口恢复情况比较"

组别 肉芽覆盖时间/d 肉芽痊愈时间/d 愈合时间/d
观察组 3.75±1.20 6.28±1.39 11.70±2.24
对照组 6.85±2.04 8.39±1.54 14.57±3.86

表6

伤口护理观察指标对比"

组别 伤口治愈
时间/d
换药
次数
换药
治疗费/万元
住院治疗
费/万元
观察组 47.2±3.3 12.5±2.4 0.6±0.4 2.6±1.7
对照组 68.3±5.8 32.8±6.3 0.5±0.3 4.1±2.3
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