4. Discussion
PUSH, ulcer, pain
PRESSURE SORE, PRESSURE ULCER, WOUND INFECTION, PRESSURE ULCERS, PRESSURE ULCERS, ULCER
Currently, pressure ulcer management is still one of the most challenging clinical issues. Variations in patients conditions and ulcer management lead to tough systematic clinical observations. The aim of the present study was to evaluate the effects of the combination of LPPL and SSD in the healing process of pressure ulcers. Our study displayed that the clinical efficacy of the combination arm was higher than that of LPPL group. Besides, the PUSH, VAS scores, and healing time were also supportive of the notion that the combination of LPPL and SSD can improve the treatment efficacy for pressure ulcers. Pressure ulcers occur due to a shortage of blood supply and removal of metabolites when the external pressure exceeds capillary blood pressure over a long time.In this study, patients with pressure ulcers from stage II to IV were included, and it was found that the wound infection rate was 70.45%. Among the pathogens of wound infection in the different stages of pressure sores (stage II and III–IV), Gram-negative bacteria accounted for the highest proportion, followed by Gram-positive bacteria, suggesting that gram-negative bacteria were the dominant pathogens in pressure sore wounds, and this finding was consistent with previous investigations.In this study, LPPL combined with silver sulfadiazine cream was used. It was confirmed that the total effective rate of the combined cream group was markedly higher; the PUSH and VAS scores were markedly lower; and the healing time of patients with stage II, III, and IV was markedly shorter. The aforementioned results suggest that the therapeutic effects of LPPL combined with the silver sulfadiazine cream are be superior to those of LPPL alone, which can relieve pain and promote the healing of pressure ulcers at different stages. Previous studies suggest that the advantage of LPPL is that it can penetrate the skin, with a depth of up to 5 cm, and reach the deep tissues, thus enhancing wound healing and immunomodulatory effects.Previous studies also mentioned that LPPL could trigger the human cellular and humoral defense, and rearrange the polar heads of the lipid bilayer in cell membranes thus enhance enzyme reactions.Despite the encouraging therapeutic effects of the combined group on pressure ulcers, our study still had several limitations. First, the number of patients that were included in this study is limited, leading to a lower statistical power. Moreover, the evolution of bacterial microbiota is needed to provide dynamic changes in the composition of the microbiota species in the wound. Besides, conventional management of pressure ulcers could be included as the control group to discuss the advantages and shortcomings of our treatment arms.To sum up, infections in pressure ulcer wounds are mainly caused by Gram-negative bacteria, based on routine nursing. LPPL combined with silver sulfadiazine cream has beneficial effects on the treatment of stage II to IV pressure ulcers, which can promote wound healing, thereby reducing patient’s suffering. Due to its simple and feasible application, this combination treatment is worth popularizing and its clinical use is a possible option in the future (Fig. Clinical observation of LPPL combined with silver sulfadiazine cream in the treatment in different stages of pressure ulcers. LPPL = linear polarized polychromatic light.