A randomized clinical trial of silver hydrofiber dressing versus collagenase ointment for venous ulcer: analysis of biofilm-producing bacteria and bacterial clonality

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia Pub Date : 2025-07-14 DOI:10.1016/j.abd.2025.501162

Taís Lopes Saranholi , Natalie Carlos Ferreira Mello Sampaio , Hélio Amante Miot , Stéfani Thais Alves Dantas , Vera Lucia Mores Rall , Luciana Patricia Fernandes Abbade

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引用次数: 0

Abstract

Background

Superficial infection in venous ulcers (VU) hinders healing.

Objective

To evaluate the action of hydrofiber dressing with silver (HAg) compared to collagenase ointment (Col) in VU.

Methods

Randomized controlled clinical trial in which patients with VU with superficial infection were randomized to the intervention (HAg) or comparison (Col) group. After 30 days (T30), the primary outcomes evaluated were: rate of ulcers without signs of superficial infection, decrease in bacterial load, presence of biofilm-producing bacteria, and bacterial clonality.

Results

Thirty-four patients (56 ulcers) were included ‒ 18 patients (28 ulcers) in the HAg group and 16 (28 ulcers) in the Col group. There was a reduction in ulcers with superficial infection in both groups over time but with no differences (p = 0.422). There was no decrease in total bacterial load over time (p = 0.054) or between the groups (p = 0.113). There was a reduction in the rate of ulcers with biofilm-forming bacteria over time (p = 0.047) but no differences between groups (p = 0.558). Regarding the clonality of Staphylococcus aureus, 92.8% of ulcers in the HAg group and 85% in the Col group, the clones identified at T0 were the same at T30 (p = 0.553). There was no change in the identity of Pseudomonas aeruginosa in any ulcer in either group.

Study limitations

Short follow-up time.

Conclusion

Both interventions improved the clinical and some microbiologic characteristics, but there was no difference between both interventions. In addition, most ulcers showed indistinguishable genetic profiles of S. aureus and P. aeruginosa between T0 and T30, with no difference between the groups.

查看原文本刊更多论文

银纤维敷料与胶原酶软膏治疗静脉溃疡的随机临床试验：生物膜生成细菌和细菌克隆性分析

背景：静脉溃疡（VU）的浅表感染阻碍愈合。目的比较银纤维敷料（HAg）与胶原酶软膏（Col）在VU中的作用。方法随机对照临床试验，将VU合并浅表感染患者随机分为干预组（HAg）和对照组（Col）。30天后（T30），评估的主要结果是：无浅表感染征象的溃疡发生率、细菌负荷的减少、产生生物膜的细菌的存在和细菌的克隆性。结果共纳入34例患者（56个溃疡），其中HAg组18例（28个溃疡），Col组16例（28个溃疡）。随着时间的推移，两组的浅表感染溃疡减少，但没有差异（p = 0.422）。细菌总负荷没有随着时间的推移而减少（p = 0.054），组间也没有减少（p = 0.113）。随着时间的推移，形成生物膜细菌的溃疡发生率有所降低（p = 0.047），但两组之间没有差异（p = 0.558）。对于金黄色葡萄球菌的克隆性，HAg组92.8%的溃疡和Col组85%的溃疡，T0时鉴定的克隆在T30时相同（p = 0.553）。两组溃疡中铜绿假单胞菌的特征均无变化。研究局限：随访时间短。结论两种干预措施均能改善患儿的临床及部分微生物学特征，但两种干预措施之间无显著差异。此外，大多数溃疡在T0和T30之间显示出难以区分的金黄色葡萄球菌和铜绿假单胞菌的遗传谱，两组之间没有差异。

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来源期刊

Anais brasileiros de dermatologia DERMATOLOGY-

CiteScore

2.40

自引率

0.00%

发文量

184

审稿时长

32 days

期刊介绍： The journal is published bimonthly and is devoted to the dissemination of original, unpublished technical-scientific study, resulting from research or reviews of dermatological topics and related matters. Exchanges with other publications may be accepted.