Article: Use of low-frequency contact ultrasonic debridement with and without polyhexamethylene biguanide in hard-to-heal leg ulcers: an RCT.
2022 Volume 31, Issue 8, Page(s) 670–681
Abstract: Objective: The primary aim of this research was to investigate the combination effect of polyhexamethylene biguanide (PHMB) and low-frequency contact ultrasonic debridement (LFCUD) on the bacterial load in hard-to-heal wounds in adults, compared with ... ...
| Abstract | Objective: The primary aim of this research was to investigate the combination effect of polyhexamethylene biguanide (PHMB) and low-frequency contact ultrasonic debridement (LFCUD) on the bacterial load in hard-to-heal wounds in adults, compared with ultrasonic debridement alone. Secondary outcomes included wound healing, quality of life (QoL) and pain scores. Method: In this single-blinded, randomised, controlled trial participants were randomised to two groups. All participants received LFCUD weekly for six weeks, plus six weeks of weekly follow-up. The intervention group received an additional 15-minute topical application of PHMB post-LFCUD, at each dressing change and in a sustained dressing product. The control group received non-antimicrobial products and the wounds were cleansed with clean water or saline. Wound swabs were taken from all wounds for microbiological analysis at weeks 1, 3, 6 and 12. Results: A total of 50 participants took part. The intervention group (n=25) had a lower bacterial load at week 12 compared with the control group (n=25) (p<0.001). There was no difference in complete wound healing between the groups (p=0.47) or wound-related QoL (p=0.15). However, more wounds deteriorated in the control group (44%) compared with the intervention group (8%, p=0.01). A higher proportion of wounds reduced in size in the intervention group (61% versus 12%, p=0.019). Pain was lower in the intervention group at week six, compared with controls (p=0.04). Conclusion: LFCUD without the addition of an antimicrobial agent such as PHMB, cannot be recommended. Further research requires longer follow-up time and would benefit from being powered sufficiently to test the effects of multiple covariates. |
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| MeSH term(s) | Adult ; Biguanides ; Debridement ; Humans ; Leg Ulcer/therapy ; Pain/drug therapy ; Quality of Life ; Ultrasonics ; Wound Healing |
| Chemical Substances | Biguanides ; polihexanide (322U039GMF) |
| Language | English |
| Publishing date | 2022-08-24 |
| Publishing country | England |
| Document type | Journal Article ; Randomized Controlled Trial |
| ZDB-ID | 1353951-6 |
| ISSN | 0969-0700 |
| ISSN | 0969-0700 |
| DOI | 10.12968/jowc.2022.31.8.670 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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