用半渗透性聚氨基甲酸酯敷料处理供皮区

口腔颌面外科手术如前庭成形术,常需植皮,目前常用的敷料有供皮区疼痛、创面渗液,不便沐浴、污染衣服和床单等缺点。近来已有一种新型敷料方便地应用到厚断层皮肤移植的供皮区。这种敷料是一种薄的、透明的、半渗透性聚氨基甲酸酯薄膜,聚氨基甲酸酯借助聚乙烯醚粘贴在薄膜的一边,敷料有弹性,可很好的适应创面。此半渗透性敷料(Semipermeable dressing SPD)可以阻止细菌及水份的侵入,但不防碍空气和水蒸气的通透性。因此在敷料下提供了一个湿润的创面环境,并可察看敷料下创面愈合的全过程。可以清楚辨认创面感染而及时加以处理。敷料与创面周围边缘皮肤粘着良     

光固化牙周敷料在预成义齿的应用

光固化牙周敷料在预成义齿的应用第一军医大学南方医院（邮５１０５１５）任煜光材料与方法我们使用的是美国Ｄｅｎｔｓｐｌｙ管装光固化树脂型牙周敷料，国产钨灯可见光固化器（口内用ＧＤ－２型及口外用ＪＴＧ－１型）。方法：拔牙前取模，按常规作需拔除牙的预成义齿。...     

口腔黏膜病

PD-L1、PD-L2mRNA在OLP组织中的表达研究,应用无机活性元素敷料治疗老年入术后难愈性创面溃疡的初步报告，β-胡萝卜素联合醋酸曲安奈德治疗口腔均质型白斑的临床应用,黄连清心饮治疗灼口综合征的临床疗效观察,国内灼口综合征抗抑郁药物治疗循证医学分析.     

明胶海绵替硝唑敷料治疗干槽症疗效观察

目的 总结吸收性明胶海绵替硝唑敷料治疗干槽症的临床疗效。方法 应用吸收性明胶海绵替硝唑敷料治疗46例干槽症，其中男性28例，女性18例，病情重者全身配合应用抗生素。结果 总有效率达97．8％，取得了满意的效果。结论 吸收性明胶海绵替硝唑敷料具有止痛，持续性消炎、抗菌作用及促进创口愈合作用。     

活性创口敷料在口腔中的应用

本文介绍我科采用活性创口敷料在口腔出血、损伤中的应用体会。　　作者单位:210001南京市中医院口腔科　　1.一般资料:本组观察128例,其中男83例,女45例,年龄2～86岁,平均年龄41.58岁。颌面外伤34例,各类疾病引起的口腔出血27例,拔牙后出血67例。2.方法:本组所用活性创口敷料为中国药科大学生物工程药厂产品。对外伤所致粘膜或皮肤创口彻底清创后将活性创口敷料放置于创面包扎。拔牙后的出血,置活性创口敷料于牙槽窝内填塞止血。其它疾病引起的龈出血,在找到明确出血部位后,将活性创口敷料在出血点处填塞压迫止血。3.结果:34例外伤,均达到…     

褐藻胶可吸收止血敷料在拔牙术后的应用小结

褐藻胶可吸收性止血敷料是海藻的天然产物,具有高度的吸液性、良好的止血性和生物降解性.我们自1992年5月以来,在门诊口腔科作为拔牙术后创面的止血材料,取得了良好效果,现小结如下:一、临床资料1.使用褐藻胶可吸收止血敷料的病人共52例,57颗牙.其中男32例,女20例.年龄13～78岁.2.52例中:牙周炎27例,残根、残冠18例,阻生牙8例,其它4例.均为极度松动的牙齿,不可修复的残根、残冠、反复发作冠周炎的阻生牙等.     

物理抗菌喷雾敷料在口腔癌术创预防感染的研究

目的:研究口腔癌术创全身应用抗菌药物的同时,局部应用物理抗菌方法的临床治疗效果。方法:60例口腔癌患者,随机分为治疗组30例和对照组30例。治疗组,从手术当日开始,在口腔、口咽、鼻咽部以及颈部术创喷涂洁悠神物理抗菌喷雾敷料,剂量为0.1mL/次,每日3次,直到术创愈合。对照组,常规口腔护理、换药。观察两组术创外观、愈合等级和愈合时间,血常规、肝肾功能等血液学检测。结果:两组术创愈合等级无显著差异(P>0.05),术创愈合时间治疗组较对照组缩短(P<0.05)。60例均未出现不良反应,用药后血液学检测无显著差异(P>0.05)。结论:口腔癌术后创面局部使用物理抗菌雾敷料在预防感染的安全性和有效性综合指标方面有一定的优势。     

丝素蛋白抗菌性修饰在皮肤组织工程中的应用

丝素蛋白（silk fibroin，SF）是一种天然高分子纤维蛋白，常被作为理想敷料应用于口腔颌面部及全身皮肤创面的修复中。SF具备良好的生物相容性、可降解性、机械性能，可促进创面愈合，但其本身不具备抗菌性。通过不同抗菌性修饰赋予SF材料抗菌性能已得到广泛的研究和关注。本文对SF抗菌性修饰材料在皮肤组织工程中的应用进行系统性介绍，为今后开展SF抗菌性支架材料研究提供思路和指导。     

封闭负压引流术(VSD)应用进展

封闭负压引流技术(VSD)将负压引流与封闭敷料相结合,早期用于治疗开放性骨折,后来被不断改良和推广。在综合各类相关文献的基础上,对该技术在软组织创面、骨组织创面、慢性难愈性创面、皮肤及骨组织移植中的特点及临床应用进行了初步总结,并对VSD在口腔颌面外科领域的应用进行了展望。     

过氧化脲漂白剂对釉质显微硬度影响的实验研究

目的:评价不同载体和浓度的过氧化脲(carbam ide peroxide,CP)漂白剂对釉质表面显微硬度的影响。方法:在18个离体前磨牙的颊、舌面各制备2 mm×2 mm的平面,随机分为6组。分别用卡波姆(Car-bopol)、聚乙烯吡咯烷酮(PVP)或泊洛沙姆(poloxam er)为增稠载体的含11%、21%CP的漂白剂,在37℃100%湿度条件下每天漂白6~8 h,持续2周。漂白前、后测量釉质表面的显微硬度。21%CP治疗组在漂白治疗结束后继续浸入人工唾液2周,再次测量显微硬度。结果:11%CP漂白2周后,釉质的显微硬度与漂白前相比没有显著差异(P>0.05);21%CP漂白2周后,釉质的显微硬度明显低于漂白前(P<0.01),继续浸入人工唾液2周,显微硬度明显高于漂白后(P<0.05),但与漂白前相比仍有显著差异(P<0.05)。在相同CP浓度下,不同增稠载体组间的显微硬度没有显著差异(P>0.05)。结论:11%CP漂白剂对釉质的显微硬度没有影响,21%CP漂白剂可明显降低釉质的显微硬度,人工唾液可在一定程度上增加釉质的再矿化能力,不同的增稠载体对釉质的显微硬度没有明显影响。     

Merocel semicompressive dressing to prevent donor-site hematoma on the conchal cartilage graft

Conchal cartilage grafts are commonly used in rhinoplasties; however, complications related to the donor site, including delayed wound healing and scar formation and hematoma formation, still occur. Hematoma formation is the most important and frequent complication. Conventional tie-over dressing with a bolster has been commonly used to prevent donor-site hematomas, but it does not always give satisfactory outcomes. Therefore, we have introduced a new compressive dressing technique using Merocel, which is cut in half transversely: 1 piece is used as a posterior bolster and the other piece is cut in half again (yielding 2 small pieces) to make a concavity in the conchal cartilage (one piece for cymba concha and the other piece for cavum concha, respectively). After application of Merocel, the overall complication and hematoma formation rates were significantly decreased. Our new compressive dressing technique using Merocel has several advantages. Merocel can absorb more secretions and discharge from the operative site than conventional dressings and there are no risks of tissue necrosis or ischemia due to suture tension. Also, because Merocel can be freely cut and molded and applies even pressure, it can be used on irregular surfaces. Our new compressive dressing technique using Merocel is a simple and reliable option for preventing auricular hematomas.     

Manuka honey dressing: An effective treatment for chronic wound infections

The battle against methicillin-resistant Staphylococcus aureus (MRSA) wound infection is becoming more difficult as drug resistance is widespread and the incidence of MRSA in the community increases. Manuka honey dressing has long been available as a non-antibiotic treatment in the management of chronic wound infections. We have been using honey-impregnated dressings successfully in our wound care clinic and on the maxillofacial ward for over a year.     

辐射交联水凝胶创面敷膜的实验研究

本文介绍了应用高分子水凝胶材料进行医用敷膜的研究。在配方、制作上采用复合配伍及辐射交联新工艺、经测试、物理性、生物性良好,符合医用标准,临床试用效果满意,是一种新颖的创面外用材料。     

Evaluation of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated dressing on surgical wounds

The ideal dressing material is bio-inert and keeps the wound site moist. It is equally important that no regenerative tissue is peeled off on the removal of the dressing. 2-Methacryloyloxyethyl phosphorylcholine (MPC) has a phospholipid polar group that mimics a biomembrane. We prepared poly [MPC-co-n-dodecyl methacrylate (DMA)] (PMD), using conventional radical polymerization with 2,2'-azobisisobutyronitrile as an initiator, and coated it on polyurethane (PU; Tecoflex 60 Thermedics Inc.) membrane. Full-thickness surgical wounds were made on the dorsal skin of rats and wound healing was compared under the following three conditions: air-exposed control (no dressing), PU dressing, and PMD dressing. At 3, 4 and 7 days after the operation, the wound sizes of the PMD dressings were smaller than the non-dressed wound, and at 6 and 7 days after the operation, the wound sizes of PU dressing were smaller than that of the air-exposed group. But there were no significant difference between the PMD dressing group and PU dressing group. Histologically, scab formation was not observed on the PU or PMD-dressed wounds. However, in the air-exposed control, a scab was formed and re-epithelialization of the wound site was prevented. Additionally, no damage was observed in the histological section of PMD dressed wound after the wound was cured. These results indicate that PMD dressing (PMD-coated PU membrane) has the potential to provide an inert environment for wound healing as well as PU.     

应用无机活性元素敷料治疗老年人术后难愈性创面溃疡的初步报告

目的：观察无机活性元素敷料在老年患者难愈性创面溃疡修复中对皮肤创面愈合的作用。方法：收集3年中我科70岁以上老年患者术后出现创面愈合困难病例5例，接受无机活性元素敷料10mg／cm^2治疗，观察治疗5d、10d创面愈合情况，计算10d后创面愈合缩小率。结果：治疗5d时即出现创面愈合过程，10d时达到创面缩小率为83．2％。结论：无机活性元素敷料在老年患者皮肤损伤修复中，对皮肤创面有明显的促进愈合作用。     

Effects of a fibrin-sealant wound dressing on the healing of full-thickness wounds of the hard palate: preliminary report

The objective of the present study was to determine the effects of a fibrin sealant (Tisseel) on wound healing. The sealant tested is produced from human plasma. This study involved 12 adult beagle dogs, all of which underwent creation of full-thickness palatal wounds. Six animals received immediate application of a fibrin sealant as a wound dressing. Polaroid photographs were taken immediately after creation of the palatal wounds and at regular intervals during the healing period. Six measurements were obtained from these photographs. Longitudinal comparisons of the profile of the mean curves for the relative changes during the 38-day study period indicated that the six parameters investigated have similar curve profiles in both the fibrin-sealant treated wounds and the untreated control wounds. The overall direction of healing was not significantly different in the two groups. However, comparisons of the curve magnitudes indicated that there was a significantly greater reduction in wound size in the fibrin sealant treated group. Cross-sectional comparisons (analysis of variance General Linear Models procedure) indicated that in the first 2 weeks there was a relatively greater reduction in wound width in the fibrin sealant treated group of animals. No significant differences were present at the end of the experimental period. The findings of this study indicated that the fibrin sealant when used as a dressing on palatal wounds of adult beagle dogs resulted in greater wound contraction in the early stages of wound healing.     

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide

abstract — The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); II teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 5996. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.     

新型含药聚乙烯醇水凝胶创面敷膜的细胞毒性研究

本研究采用改进的细胞相对增殖度法和细胞形态学方法研究了新型含药聚乙烯醇创面敷膜的组织相容性。含药ＰＶＡ敷膜第２，４，７天的细胞相对增殖度分别为８６％，９５％和１０２％，基本无细胞毒性。通过分别于第２４。４８，７２小时的形态学观察可见，与敷膜接触的细胞生长状态良好。因此此敷膜具有良好的组织相容性     

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide.

The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); 11 teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 59%. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.