红霉素软膏对趾挤压伤拔甲后创面换药观察

目的观察红霉素软膏应用于趾挤压伤患者行拔甲术后创面换药的临床效果。方法选择我院100例（105趾）趾挤压伤拔甲术患者,随机分为对照组50例（51趾）和实验组50例（54趾）。对照组创面换药覆盖凡士林纱布,无菌敷料包扎;实验组在对照组基础上加用红霉素软膏。结果实验组去敷料时NRS评分、伤口创面、换药次数及愈合时间情况均显著优于对照组（P〈0．01）。结论红霉素软膏用于趾挤压伤患者行拔甲术后创面换药能够有效缓解患者疼痛,促进创面愈合,值得在临床上推广应用。     

伤疡愈软膏对实验性金黄色葡萄球菌所致的伤疡创面溶菌酶含量的影响

目的：通过对金黄色葡萄球菌造模的大鼠伤疡动物模型实验，观察给药后创面分泌物对溶菌酶含量的影响，证实伤疡愈软膏具有抗菌、抗炎，化腐生肌促进伤口愈合的功效。方法：采用大鼠为疮疡动物模型进行造模，取给药后第7天创面分泌物进行测定。结果：给药组与赋形剂组相比抑菌圈直径差异具显著性（P〈0．01）。结论：伤疡愈软膏能显著提高大鼠伤疡模型创面分泌溶菌酶，促使脓液排出．加快伤口的愈合。     

液体创伤敷料的生物相容性和伤口愈合研究

摘要：目的:考察液体创伤敷料的生物相容性,评价其对伤口的愈合作用。方法:采用小鼠上皮成纤维细胞株（L-929）进行实验,以CCK-8法检测不同浓度液体创伤敷料薄膜浸提液对细胞增殖的影响情况;采用KM小鼠皮肤全切除实验模型,敷以液体创伤敷料和美国强生邦迪创可贴,通过对比观察和皮肤切片染色,评估皮肤伤口的愈合情况。结果:不同浓度的薄膜浸提液对L-929细胞增殖均有一定的促进作用;肉眼观察和病理切片结果显示液体创伤敷料组相较于邦迪创可贴和空白伤口组,伤口愈合速度更快。结论:所制得的液体创伤敷料不仅具有良好的生物相容性,还能够促进皮肤伤口愈合。     

头花蓼纳米纤维功能敷料的药效评价

目的 评价头花蓼纳米纤维功能敷料（P-PVP-PCL）的药效。方法 利用静电纺丝技术制备P-PVP-PCL,观察其微观形貌;考察P-PVP-PCL的抑菌活性、抗氧化活性和对小鼠成纤维L929细胞存活率、黏附性及迁移率的影响。通过建立大鼠背部皮肤伤口模型,考察医用纱布敷料、空白纳米纤维敷料（PVP-PCL）和P-PVP-PCL对创面愈合率的影响,观察创面组织病变和胶原纤维沉积情况,以及创面组织中血小板内皮细胞黏附分子1(CD31)阳性血管数量和转化生长因子β(TGF-β)蛋白表达。结果 制得的PPVP-PCL表面光滑,断面处可见双层结构,对金黄色葡萄球菌和大肠埃希菌的抑制率分别为（98.88±0.66）%、（94.75±1.41）%,抗氧化活性为（83.69±1.56）%,且P-PVP-PCL组的细胞活性均显著高于对照组和PVP-PCL组（P<0.05）。与医用纱布敷料相比,PPVP-PCL更有利于L929细胞黏附;在48 h时,该组的细胞划痕已基本愈合。与医用纱布敷料组比较,PVP-PCL组和P-PVP-PCL组的大鼠创面愈合率均显著升高（P<0.05）。干预第14天时,P...     

液体伤口敷料用于治疗皮肤浅表损伤的疗效与安全性临床研究简

皮肤浅表损伤是外科临床工作中常见的外伤类型,尤以颜面部等身体暴露部位多见,具有创伤面积较大、易感染、创口不规则等特点;同时常规换药疗程较长,程序繁琐,疗效不够肯定;并且愈后病灶易形成瘢痕[1].故临床上需要一种使用方便、安全性高、疗程短、疗效肯定的治疗方法及配套制剂.液体伤口敷料以聚乙烯醇、甘油等为主要成膜组分,加入冰片、松香等成分,融合易挥发的酒精和水等组成.本品通过富有弹性、张力、半透气性的胶膜封闭创面,在敷料与创面间营造成一个防水、低氧、微酸的湿润环境,抑制创面的细菌生长,促进纤维细胞的合成及刺激血管增生,从而达到不产生结痂,减轻伤口的疼痛,促进伤口愈合,迅速修复真皮的目的.本次临床研究采用多中心、随机、阳性平行对照研究.选择80 例以皮肤浅表损伤（如切伤、裂伤、擦伤、烧烫伤、缝合伤口）作为适应证的患者,评价液体伤口敷料治疗皮肤浅表损伤的有效性与安全性.     

不同方法处理糖尿病足溃疡的效果观察

目的：评价三种方法处理糖尿病足溃疡的治疗效果。方法将门诊换药室就诊的60例Wangner分级Ⅱ～Ⅲ级糖尿病足溃疡的患者采用随机数字表法分为生物活性敷料组、新型敷料组和传统敷料组。生物活性敷料组采用联合清创,银离子敷料控制感染,藻酸盐敷料和泡沫敷料管理渗液的换药方法,另外加用生物活性敷料（皮肤创面无机诱导活性敷料德莫林）促进肉芽生长;新型敷料组前期处理同生物活性敷料组,只是未加用生物活性敷料;传统敷料组选用碘仿纱条和凡士林纱布换药。结果伤口处理6周时,伤口愈合总有效率生物活性敷料组明显优于传统敷料组（ P ＜0．01）,且生物活性敷料组优于新型敷料组（ P ＜0．05）;伤口面积减小率,伤口愈合计分生物活性敷料组明显优于传统敷料组（ P ＜0．01）。溃疡愈合时间较传统敷料组明显缩短（ P ＝0．000）,且优于单纯应用新型敷料换药（ P ＝0．002）。结论新型敷料联合生物活性敷料（皮肤创面无机诱导活性敷料德莫林）治疗糖尿病足溃疡总有效率明显高于传统敷料组,溃疡愈合速率较传统敷料组明显加快,取得满意疗效。     

鞣酸软膏基质及配制的改进

皮肤疾患常用软膏或霜剂涂布后再加敷料包扎，在创面较大时包扎起来很不方便，或让其暴露。本人在鞣酸软膏配制的基础上，对基质作了改换，设计了一新组方，制作后使用于一般烧伤、烫伤、皮肤磨削伤、炎症、溃疡等皮肤疾患，较原来使用软膏方便，并很适合作为家庭备药。     

羧甲基纤维素钠敷料在急性伤口中的应用

“湿性愈合理论”认为,将创面置于一个封闭、湿润的环境中,有利于创面的加速愈合。封闭敷料（occlusive dressings）是在“湿性愈合理论”指导下研发的新型伤口敷料。其中应用最多的水胶体敷料其基本成分是羧甲基纤维素钠（sodium carboxymethyl cellulose,CMC）,具有吸收创面渗液形成凝胶的特性,可以起到保持创面适宜的温湿度、支撑创面的作用。本文对羧甲基纤维素钠在急性伤口中的应用进行简述。     

莫匹罗星软膏对拔甲术后伤口愈合的效果观察

目的观察莫匹罗星（百多邦）软膏对拔甲术后伤口愈合的效果观察。方法将50例（共计52趾）拔甲患者,随机分观察组和对照组,观察组在常规拔甲术后换药中用莫匹罗星软膏涂抹甲床创面,并覆盖雷弗奴尔湿纱条,对照组在术后换药中不涂莫匹罗星软膏,直接用雷弗奴尔湿纱条覆盖甲床创面,直到伤口愈合。观察两组患者换药时去除伤口敷料时的疼痛程度、伤口愈合时间及换药次数。结果观察组去除伤口敷料时的疼痛程度明显低于对照组,伤口愈合时间及换药次数均少于对照组,两组比较有统计学意义（P〈0.05）。结论在拔甲术后伤口换药中使用莫匹罗星软膏,可有效地减轻换药疼痛,减少粘贴、缩短伤口愈合时间及减少换药次数。     

伤疡愈软膏在伤口愈合中对细胞生长水平的影响

目的:通过对用药各个时期伤口渗出组织液细胞生长水平的测定,探讨伤疡愈软膏在促进伤口愈合中对细胞的影响。方法:通过台盼蓝染色计数法、MTT细胞数测定法的比对及Con A和LPS诱导的细胞增殖反应。结果:伤疡愈软膏能增加细胞增生,促进B细胞、T细胞淋巴细胞增殖。结论:伤疡愈软膏具促进伤口内细胞增殖,促伤口愈合的作用。     

鱼皮胶原蛋白-壳聚糖复合海藻酸盐水凝胶敷料对烧烫伤创面的促愈合作用

本文以海藻酸钠为原料,复配壳聚糖、鱼皮胶原蛋白,通过Ca2+离子交联制备成海藻酸盐水凝胶敷料。测试了该敷料的物理机械性能及其对大白兔浅Ⅱ度烧烫伤创面的促愈合作用。结果表明：鱼皮胶原蛋白-壳聚糖复合海藻酸盐水凝胶的含水量≥80%,具有良好的吸湿保湿和机械性能,是一种理想的伤口创面敷料;对浅Ⅱ度烧烫伤的愈合周期远远少于医用纱布、市售聚氨酯水凝胶敷料,且能消除伤口炎症,抑制瘢痕的生成,在伤口护理方面有着良好的前景和应用方向。     

以硝化纤维为膜材的伤口敷料的制备及处方优化

目的 制备一种以硝化纤维为膜材的创伤敷料,并对其处方进行优化。方法 对市售产品进行部分分析,采用硝化纤维作为成膜材料,以苯甲醇为抑菌剂,蓖麻油为增塑剂,棕榈酸异丙酯为皮肤柔润剂,樟脑作为芳香剂,以异丙醇、乙酸乙酯、乙酸丁酯为挥发溶剂制备创伤敷料。分别对所成膜的抗张强度、断点伸长百分率、透气防水性能等进行考察评价。结果 所制备液体创伤敷料成膜性能良好,确定硝化纤维的最终使用量为6%、蓖麻油的使用量为4%。结论 研究所制得的液体创伤敷料成膜性好,有良好的机械性能,并具备较好的防水能力及一定的透气性能。     

Antibacterial biomaterials for skin wound dressing

Bacterial infection and the ever-increasing bacterial resistance have imposed severe threat to human health. And bacterial contamination could significantly menace the wound healing process. Considering the sophisticated wound healing process, novel strategies for skin tissue engineering are focused on the integration of bioactive ingredients, antibacterial agents included, into biomaterials with different morphologies to improve cell behaviors and promote wound healing. However, a comprehensive review on anti-bacterial wound dressing to enhance wound healing has not been reported. In this review, various antibacterial biomaterials as wound dressings will be discussed. Different kinds of antibacterial agents, including antibiotics, nanoparticles (metal and metallic oxides, light-induced antibacterial agents), cationic organic agents, and others, and their recent advances are summarized. Biomaterial selection and fabrication of biomaterials with different structures and forms, including films, hydrogel, electrospun nanofibers, sponge, foam and three-dimension (3D) printed scaffold for skin regeneration, are elaborated discussed. Current challenges and the future perspectives are presented in this multidisciplinary field. We envision that this review will provide a general insight to the elegant design and further refinement of wound dressing.     

Evaluation of semi-interpenetrating polymer networks composed of chitosan and poloxamer for wound dressing application

We have elsewhere reported the work on the preparation of semi-interpenetrating polymer networks (SIPNs) composed of chitosan (CS) and poloxamer to improve the mechanical strength of CS sponge. This study focuses on evaluation of the CS/poloxamer SIPNs to intend for wound dressing application and the efficacy of dehydroepiandrosterone (DHEA)-loaded CS/poloxamer SIPNs in the wound model studies. The properties required for ideal wound dressing, such as equilibrium water content (EWC), water absorption (A(w)), water vapor transmission rate (WVTR), and evaporative water loss, were examined. The CS/poloxamer SIPNs were found to have a water content of 90% of their weight which could prevent the wound bed from accumulation of exudates and also have excellent water adsorption. The WVTR of CS/poloxamer SIPNs was found to be 2,508.2+/-65.7gm(-2)day(-1), indicating that the SIPNs can maintain a moist environment over wound bed in moderate to heavily exuding wound which enhances epithelial cell migration during the healing process. Also, the CS/poloxamer SIPNs in vitro assessment showed proper biodegradation and low cytotoxicity for wound dressing application. The wound healing efficacy of CS/poloxamer SIPNs as a wound dressing was evaluated on experimental full thickness wounds in a mouse model. It was found that the wounds covered with CS/poloxamer SIPNs or DHEA-loaded CS/poloxamer SIPNs were completely filled with new epithelium without any significant adverse reactions after 3 weeks. The results thus indicate that CS/poloxamer SIPNs could be employed in the future as potential wound dressing materials.     

Wound Dressings Based on Chitosans and Hyaluronic Acid for the Release of Chlorhexidine Diacetate in Skin Ulcer Therapy

In the present work wound dressings, based on chitosan hydrochloride (HCS), 5-methyl-pyrrolidinone chitosan (MPC), and their mixtures with an anionic polymer, hyaluronic acid (HA), were prepared by freeze-drying. Chlorhexidine diacetate (CX) was used as an antimicrobic drug. The mechanical properties of the wound dressings were investigated. In particular, the wound dressings were subjected to dynamic hydration measurements to evaluate their capability to absorb wound exudate and to rheological analysis to investigate their resistance to mechanical stresses on hydration. The wound dressings were also characterized for drug release properties. The antioxidant and antimicrobial activities of medicated and non-medicated wound dressings were also investigated. All the wound dressings are characterized by mechanical resistance suitable for skin application. The addition of hyaluronic acid to chitosans leads to a reduction in wound dressing hydration properties and a modulation of drug release. The wound dressing based on MPC is characterized by the highest elastic properties and by the best scavenger activity. Antimicrobial activity against bacteria and C. albicans is shown by the dressing based on chitosan also in absence of chlorhexidine.     

Antimicrobial PLGA ultrafine fibers: Interaction with wound bacteria

The structure and functions of polymer nanofibers as wound dressing materials have been well investigated over the last few years. However, during the healing process, nanofibrous mats are inevitably involved in dynamic interactions with the wound environment, an aspect not explored yet. Potential active participation of ultrafine fibers as wound dressing material in a dynamic interaction with wound bacteria has been examined using three wound bacterial strains and antimicrobial fusidic acid (FA)-loaded electrospun PLGA ultrafine fibers (UFs). These were developed and characterized for morphology and in-use pharmaceutical attributes. In vitro microbiological studies showed fast bacterial colonization of UFs and formation of a dense biofilm. Interestingly, bacterial stacks on UFs resulted in a remarkable enhancement of drug release, which was associated with detrimental changes in morphology of UFs in addition to a decrease in pH of their aqueous incubation medium. In turn, UFs by allowing progressively faster release of bioactive FA eradicated planktonic bacteria and considerably suppressed biofilm. Findings point out the risk of wound reinfection and microbial resistance upon using non-medicated or inadequately medicated bioresorbable fibrous wound dressings. Equally important, data strongly draw attention to the importance of characterizing drug delivery systems and establishing material-function relationships for biomedical applications under biorelevant conditions.     

Wound dressings based on chitosans and hyaluronic acid for the release of chlorhexidine diacetate in skin ulcer therapy

In the present work wound dressings, based on chitosan hydrochloride (HCS), 5-methyl-pyrrolidinone chitosan (MPC), and their mixtures with an anionic polymer, hyaluronic acid (HA), were prepared by freeze-drying. Chlorhexidine diacetate (CX) was used as an antimicrobic drug. The mechanical properties of the wound dressings were investigated. In particular, the wound dressings were subjected to dynamic hydration measurements to evaluate their capability to absorb wound exudate and to rheological analysis to investigate their resistance to mechanical stresses on hydration. The wound dressings were also characterized for drug release properties. The antioxidant and antimicrobial activities of medicated and non-medicated wound dressings were also investigated. All the wound dressings are characterized by mechanical resistance suitable for skin application. The addition of hyaluronic acid to chitosans leads to a reduction in wound dressing hydration properties and a modulation of drug release. The wound dressing based on MPC is characterized by the highest elastic properties and by the best scavenger activity. Antimicrobial activity against bacteria and C. albicans is shown by the dressing based on chitosan also in absence of chlorhexidine.     

An innovative bi-layered wound dressing made of silk and gelatin for accelerated wound healing

In this study, the novel silk fibroin-based bi-layered wound dressing was developed. Wax-coated silk fibroin woven fabric was introduced as a non-adhesive layer while the sponge made of sericin and glutaraldehyde-crosslinked silk fibroin/gelatin was fabricated as a bioactive layer. Wax-coated silk fibroin fabrics showed improved mechanical properties compared with the non-coated fabrics, but less adhesive than the commercial wound dressing mesh. This confirmed by results of peel test on both the partial- and full-thickness wounds. The sericin-silk fibroin/gelatin spongy bioactive layers showed homogeneous porous structure and controllable biodegradation depending on the degree of crosslinking. The bi-layered wound dressings supported the attachment and proliferation of L929 mouse fibroblasts, particularly for the silk fibroin/gelatin ratio of 20/80 and 0.02% GA crosslinked. Furthermore, we proved that the bi-layered wound dressings promoted wound healing in full-thickness wounds, comparing with the clinically used wound dressing. The wounds treated with the bi-layered wound dressings showed the greater extent of wound size reduction, epithelialization, and collagen formation. The superior properties of the silk fibroin-based bi-layered wound dressings compared with those of the clinically used wound dressings were less adhesive and had improved biological functions to promote cell activities and wound healing. This novel bi-layered wound dressing should be a good candidate for the healing of full-thickness wounds.     

糖尿病足伤口换药的临床护理分析

目的分析糖尿病足伤口换药的临床护理方案,以遴选最佳换药材料。方法辅料组患者应用医用液体辅料辅以清创机进行换药,盐水组应用生理盐水辅以清创机进行换药。比照渗液的质量,统计伤口愈合耗时及换药次数,确定换药疗效。结果辅料组其创面渗液消失耗时、创面愈合耗时及换药次数均显著低于盐水组,差异有统计学意义（P〈0．05）。辅料组伤口愈合显效率为81．94％,显著高于盐水组的56．94％（P〈0．05）,差异有统计学意义。结论应用液体敷料辅以清创机进行糖尿病足换药可大大提高换药效率,促进创面愈合,改善换药预后。     

Development and characterization of a superabsorbing hydrogel film containing Ulmus davidiana var. Japonica root bark and pullulan for skin wound healing

Ulmus davidiana var. japonica (UD) has widely been used in Korean traditional medicine for the treatment of various types of diseases including inflammation and skin wounds. The UD root bark powders possess gelling activity with an excellent capacity for absorbing water. This distinct property could make the UD root bark powders to be a great material for manufacturing a gel film specifically for the healing of large and highly exudating wounds (e.g., pressure sores and diabetic ulcers). In this research, we separated the UD root bark powder into 4 different samples based on their sizes and then tested their water absorption capacity and flowability. Based on these results, 75–150 μm sized and below 75 μm sized samples of UD root bark powders were chosen, and UD gel films were prepared. The UD gel films showed good thermal stability and mechanically improved properties compared with pullulan only gel film with excellent swelling capacity and favorable skin adhesiveness. Further, in the animal studies with the skin wound mice model, the UD gel films exhibited significant therapeutic effects on accelerating wound closure and dermal regeneration. Overall, this study demonstrated the applicability of UD root bark powders for hydrogel wound dressing materials, and the potential of UD gel films to be superior wound dressings to currently available ones.