局部应用不同浓度硝普钠对创伤愈合影响的时效性研究

目的:应用组织化学及计算机辅助图像分析方法,观察外源性一氧化氮(nitricoxide,NO)在创伤愈合过程不同时间对肉芽组织生长及成纤维细胞增殖的影响,探讨其对促进创伤愈合和抑制病理性瘢痕形成的机制。方法:60只大鼠随机分为对照组及实验A、B、C、D组,每组12只,通过建立大鼠创伤模型,并分别在创面局部应用5%葡萄糖溶液、0.5mmol/L、1mmol/L、2mmol/L和4mmol/L硝普钠,观察及测量创伤后3天、7天、10天和14天的肉芽生长情况、成纤维细胞数密度、胶原纤维面密度和肉芽组织中羟脯氨酸含量。结果:实验A、B组相对于对照组和实验C、D组表现出更好的伤口愈合,且瘢痕形成最小。结论:局部应用外源性NO具有显著的促修复作用,主要体现在伤后第7～10天,小剂量的NO促进创面愈合的作用远远大于大剂量NO。局部过量的NO聚积可阻碍正常的伤口愈合,并呈现全身毒性反应。在伤后7～10天应用外源性NO可抑制病理性瘢痕形成。     

Acceleration of wound healing by topical drug delivery via liposomes

Background: Despite intensive research, impaired wound healing remains a considerable complication. Therefore, topically applied liposome-encapsulated buflomedil hydrochloride was investigated for its ability to improve wound repair in normal (n=16) and ischemic (n=16) skin tissue. Methods: Experiments were performed using the wound healing model of the ear of hairless mice. Standardized skin wounds (4.25 mm²) were created by circular excision of the epidermal layer and the subcutaneous tissue. Liposomes were applied daily until complete neovascularization of the wound occurred. Tissue regeneration by complete epithelialization and neovascularization of the wound area, microcirculatory parameters, and leukocyte–endothelium interaction were investigated by means of intravital microscopy. Microvascular perfusion was assessed by laser-Doppler flowmetry. Results: Topical application of buflomedil liposomes led to a significantly (P<0.05) accelerated wound closure in both normal (9.6±0.7 days) and ischemic (13.4±0.1 days) skin tissue compared with animals that were treated with unloaded liposomes (controls; 13.1±0.8 days; 15.3±0.6 days). Complete neovascularization of the wound was also enhanced (P<0.05) in buflomedil-treated animals (normal tissue 18.8±0.4 days; ischemic tissue 19.6±0.7 days) compared with controls (20.6±0.6 days; 22.6±1.2 days). Conclusion: These data suggest that buflomedil-loaded liposomes might be of beneficial use for clinical wound care. Received: 20 January 1999; in revised form: 18 August 1999 Accepted: 20 August 1999     

The efficacy of topical sucralfate in improving pain and wound healing after haemorrhoidectomy procedure: A systematic review,meta‐analysis,and meta‐regression of randomised clinical trials

Pain and wound after haemorrhoidectomy constantly bothered the patient''s convenience. Recurrently, topical sucralfate is used to treat excoriations and burns. It is considered to enhance epidermal growth and tissue granulation, thus, alleviating patients'' problems. This study evaluated topical sucralfate''s feasibility, safety, and superiority after haemorrhoidectomy. We searched randomised controlled trial (RCT) studies in PubMed, Google Scholar, Europe PMC, and ClinicalTrials.gov until March 29th, 2022. We investigated the influence of topical sucralfate on pain score postoperatively (24 hours, 7 days, and 14 days), pethidine usage, diclofenac usage, and wound healing rate compared to placebo. This study was conducted following the PRISMA guidelines. This study sorted the final six studies with 439 patients underwent haemorrhoidectomy. Topical sucralfate demonstrated significant outcomes on VAS 24 hours post‐operative [Std. Mean Difference −1.00 (95% CI −1.70, −0.31), P = .005], VAS 7 days post‐operative [Std. Mean Difference −2.29 (95% CI −3.34, −1.25), P < .0001], VAS 14 days post‐operative [Std. Mean Difference −1.88 (95% CI −2.74, −1.01), P < .0001], pethidine usage within 24 hours post‐operative [Std. Mean Difference −0.62 (95% CI −0.96, −0.27), P = .0004], diclofenac usage 7 days post‐operative [Std. Mean Difference −1.76 (95% CI −2.61, −0.92), P < .0001], diclofenac usage 14 days post‐operative [Std. Mean Difference −1.64 (95% CI −2.38, −0.91), P < .0001], and wound healing rate at 28‐day post‐operative [RR 1.45 (95% CI 1.25–1.68), P < .00001]. Topical sucralfate alleviated pain, improved wound healing, and minimised the usage of pethidine and diclofenac compared to placebo.     

Evaluation of the efficacy of topical sucralfate on healing haemorrhoidectomy incision wounds and reducing pain severity: A randomised clinical trial

The healing of haemorrhoidectomy wounds is a main concern of surgeons and patients. Various modalities can improve the quality of wound care after surgery. Antibiotics and topical agents, such as solutions and ointments, have been evaluated. The current research investigates the effects of sucralfate ointment on wound healing (epithelialisation) and postoperative pain after open haemorrhoidectomy. This trial involves two groups of randomly collected patients (n = 40) who underwent open haemorrhoidectomy surgery by the Milligan‐Morgan method. A 10% topical sucralfate ointment was applied to the investigated group''s wounds, while the control group patients used Vaseline as a placebo. The present work measured the two outcomes as follows: pain severity by a Visual Analogues Scale (VAS) score and epithelialisation by a surgeon''s visual inspection. During the postoperative phase, the mean VAS was 3.70 for the investigated group and 6.90 for the control group. On the average, the completion of epithelialisation for the investigated group was on day 13 as opposed to day 20 for the control group. The topical application of sucralfate ointment on post‐haemorrhoidectomy wound is an effective method for the promotion of healing, also lessens the severity of pain, and reduces the need for analgesics.     

Wound healing by topical application of antioxidant iron chelators: kojic acid and deferiprone

Kojic acid and deferiprone are iron chelators used for skin lightening and iron‐overload treatment, respectively. As iron chelation and free radical scavenging are principal factors for wound healing, it was hypothesised that the local application of these compounds might accelerate wound healing in rats. Ointments of 3%, 6% and 9% of deferiprone and kojic acid were prepared and topical treatment was performed on in vivo wound models for 12 days twice in day for test and control groups. Topical treatment with 3%, 6% and 9% showed significant improvement in wound healing after 4 days (P < 0·001). Topical application of 3% and 6% deferiprone enhanced wound healing after 8 days (P < 0·026 and P < 0·001, respectively). Accelerated wound healing was seen using 3% and 6% deferiprone after 12 days (P = 0·003 and P < 0·001, respectively). DPPH scavenging assay was also performed to compare the antioxidant potencies of kojic acid and deferiprone. Deferiprone had more free radical scavenging power than kojic acid. Generally, deferiprone topical treatment, accelerated wound healing more than kojic acid because of its higher antioxidant and iron chelation abilities.