Polyhexanide Versus Metronidazole for Odor Management in Malignant (Fungating) Wounds A Double-Blinded, Randomized, Clinical Trial
Polyhexanide Versus Metronidazole for Odor Management in Malignant (Fungating) Wounds A Double-Blinded, Randomized, Clinical Trial
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DOI：
10.1097/won.0000000000000460
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发表时间：
2018-09-01
影响因子：
2.6
通讯作者：
Woo, Kevin
中科院分区：
文献类型：
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作者：
Villela-Castro, Diana Lima;Conceicao de Gouveia Santos, Vera Lucia;Woo, Kevin
目得：本研究的目的是比较0.2%聚双胍（PHMB）和0.8%甲硝唑对恶性伤口（MW）气味、健康相关生活质量（HRQOL）和应用后疼痛的影响。设计：双盲、随机、临床试验。在巴西圣保罗的一家转诊癌症中心住院的24名恶臭MW患者参加了该试验。参与者被随机分配接受0.8%甲硝唑溶液（对照组）或0.2% PHMB（实验组）治疗。在基线（第0天）、第4天和第8天测量研究结局。主要终点是气味，在研究期间测量其强度，质量和对参与者的影响。根据研究者的评估，在第0天和气味完全消除当天，使用Ferrans和Powers生活质量指数伤口版（FPQLI-WV）测量健康相关生活质量。使用0到10的量表测量与对照和实验溶液应用相关的疼痛强度作为次要结果。结果：20名患者（83.3%）在4天被分类为“无伤口气味”，并且100%在8天达到无伤口气味（P <0.001）。MW患者的气味控制显著影响其总体HRQOL（P = .002）。我们发现，当PHMB治疗的患者与甲硝唑治疗的患者相比，在气味消除或HRQOL方面没有差异。随着时间的推移，在疼痛测量2 groups.CONCLUSIONS：PHMB和甲硝唑显着减少恶臭MW的气味在4天内，没有统计学显着差异。没有一种解决方案被发现在气味减少的幅度或其对条件特异性HRQOL的影响方面比另一种更有效。
PURPOSE: The aim of this study was to compare the effects of 0.2% polyhexamethylene biguanide (PHMB) to 0.8% metronidazole on malignant wound (MW) odor, health-related quality of life (HRQOL), and pain upon application.DESIGN: A double-blinded, randomized, clinical trial.SUBJECTS AND SETTING: Twenty-four patients with malodorous MWs hospitalized in a referral cancer center in Sao Paulo, Brazil, participated in the trial.METHODS: Participants were randomly allocated to treatment with 0.8% metronidazole solution (control group) or 0.2% PHMB (experimental group). Study outcomes were measured at baseline (day 0), 4 days, and 8 days. The primary end point was the odor that was measured in terms of its intensity, quality, and impact on participants during the study period. Health-related quality of life was measured with the Ferrans and Powers Quality of Life Index-Wounds Version (FPQLI-WV) on day 0 and on the day when odor was completely eliminated as per evaluation by the investigators. Pain intensity related to application of the control and experimental solutions was measured as a secondary outcome using a scale of 0 to 10.RESULTS: Twenty patients (83.3%) were classified as having "no wound odor" at 4 days, and 100% achieved no wound odor by day 8 (P < .001). Odor control in patients with MW significantly influenced their general HRQOL (P = .002). We found no difference in odor elimination, or HRQOL, when patients managed with PHMB were compared to those managed with metronidazole. There were no statistically significant differences over time in pain measurement between the 2 groups.CONCLUSIONS: Both PHMB and metronidazole significantly reduced odor in malodorous MWs within 4 days. Neither solution was found to be more effective than the other in the magnitude of odor reduction or its effect on condition-specific HRQOL.