| Objective:Describe the characteristic of diabetes foot ulcer. By different temperature cleansing soution cleaned chronic wounds, analyse the difference among cleanliness of wounds, amount of bacteria residue, wound healing speed and so on, probe risk factors affecting chronic wounds among anthropometry index, metabolic index and so on; compare the rate of cleansing, different comfort level and healing rate of wounds with different temperature cleasning solutions; observe the variation of wound area, colour, wound grade in different time,, in order to explore the effective nursing intervention improving wound healing.Methods:It performed this experiment in the form of randomized controlled trial,60DFU patients were divided into three groups, the first experimental group using37℃cleasning solution, the second experimental group using40℃cleasning solution, the control group using22-24℃cleasning solution. Compare different cleanliness front and back cleaning, then compare the wound healing area, wound greade, pH before the intervention, on the4th day,7th day,14th day,21st day,28th day and35th day respectively, assess the wound healing rate.Results:(1) Before the intervention, the DFU wound grade is related with standard of culture, profession, duration of DM, Hb, FBG and HbAlc are correlated with wound grade in multiple linear regressions.(2) Getting and cultivating bacterias of wounds’surface before the intervention and4th day, the bacteria amount of wounds’surface before cleasning is1.83×106cfu/cm2and2.81×106cfu/cm2, the bacteria amount of surface wound after cleasning is0.43×106cfu/cm2and0.40×106cfu/cm2. Compare the bacteria cleaning rate among three groups, the cleaning rate in first time and average cleansing rate have the statistical difference(P<0.05), which showed the different temperature cleansing solutions can affect the bacteria cleanliness on wounds.(3) The total bacteria types in this research have Gram-positive-bacteria(G+)43 plants(46.7%),Gram-negative-bacteria47plants(51.1%), and fungus2plants(2.2%), top three G+bacterias are staphylococcus aureus, staphylococcus epidermidis, enterococcus faecalis, top three G-bacterias are pseudomonas aeruginosa, escherichia coli, bacillus proteus vulgaris.(4) Observing35th days, healing rate in control group is (68.94±17.43)%, healing rate in37℃group is (87.51±17.71)%, healing rate in40℃group is (85.09±16.71)%, healing rates in three groups have statistical difference, which showed that the different temperature cleansing solutions can affect wound healing rate and patients’ comfort levels. The patients’ comfort levels are the highest in the40℃group, the rate of healing is the fastest in the37℃group.(5) Observing changing of wounds before the intervention, on4th day,7th day,14thday,21st day,28th day, and35th day, areas and wound grade of all wounds greatly reduced on14th day, pH transformed from alkaline to faintly acid on21st day.Conclusion:(1) Severity of DFU is related with standard of culture, profession, duration of DM, Hb, FBG, HbAlc. If standard of culture, Hb and FBG are lower, duration of DM is longer, and HbAlc is higher, the chronic wounds are worse than before.(2) The types of bacterias on DFU surface are G+bacterias, G-bacteria and fungals. Deeper the wounds location, easier infected by G-bacterias.(3) Warm cleasning solution can increase the rate of cleasning, the amount of bacterias on the wounds surface in37℃group is less than others, the effect in first cleasning and average cleasning have difference in statistics.(4) Warm cleasning solution can increase the healing rate of chronic wounds. Compare with each other, the comfort lever in40℃group are best, the healing rate in37℃group are also best. |
PDF Full Text Request