胶原海绵作为止血和创面敷料的临床实验

目的　本文就医用吸收性胶原海绵 (简称胶原海绵 )和明胶海绵在出血创面治疗上进行详细的临床实验对比。方法　对收治的 16 4例出血创面患者 ,按住院顺序和创面类型 (急性、手术止血和残腔填充 )随机分为实验组和对照组。实验组采用胶原海绵治疗 ,而对照组用临床上常用的明胶海绵。根据创面止血愈合时间及其疗效评价等级标准 ,判定两组间的差别。通过分析两种材料的组分组成差异 ,评价创面止血与修复作用。结果　 87例实验组的临床治疗有效率 97.7%(85 /87) ,明显高于 77例对照组的 6 2 .3%(48/77) ;实验组各类型出血创面的止血时间 ,明显短于相应的对照组 (P <0 .0 1)。结论　由I型胶原组成的胶原海绵与含有较多低相对分子量组分的明胶海绵相比 ,是临床上较优异的创面止血与修复材料。     

几种胶原型创伤敷料制作的实验研究

介绍了几各胶原型创伤敷料研制的方法。冷冻牛腱经０．０５Ｍ乙酸处理（ＰＨ３．２）４８－７２ｈ后，捣碎过滤、脱泡、加太酸软骨素（８％），制成１．５－２．５％胶原溶液。该溶液在预冷或不预冷的模具内冷冻干燥，冻干的胶的海绵在０．２５％戊二醛溶液中交联２４ｈ。并以类似的方法研制成聚氨酯膜－胶原海绵复合膜，涂聚氨酯胶原膜，和纱布胶原膜三种创伤敷料。结果表明冷冻牛腱胶原性能稳定，冻干的胶原海绵具有良好的孔洞结构     

CG创伤敷料的研制

以壳聚糖、明胶和甘油为基本原料，选用戊二醛为交联剂，探讨了交联反应的条件，避免了明胶蛋白与壳聚糖的静电沉淀反应。成膜后经再处理，制备出一种含水率高、透明的多孔网状纤维膜样的创伤敷料。该敷料的扯断强度为６．５ＭＰａ，扯断伸长率为２１０％，撕裂强度为５．３ＫＮ／ｍ，含水率为７６％。通过动物实验，证明该膜具有良好的组织相容性，对防止感染、促进伤口愈合起到良好的作用，适合作创伤敷料     

几丁糖/海藻酸敷料止血性能的实验研究

目的研究一种新型敷料：几丁糖／海藻酸敷料（本项目组自行研制，已申请国家专利）的止血性能。方法取新西兰兔4只，在背部两侧对称性剪5个直径1cm的圆型创口，分别与创面大小相当的几丁糖／海藻酸敷料和明胶海绵止血，观察与创面的粘附情况，记录出血时间：止血停止后，将几丁糖／海藻酸敷料和明胶海绵放入预先配制好的氰化高铁血红蛋白检测试剂中仔细清洗，用分光光度计在540nm波长处光度比色，测出的Hb光度吸收值表示出血量。结果几丁糖／海藻酸敷料与创面粘附较好，几丁糖／海藻酸敷料、明胶海绵组的出血时间分别为87.7±19.1妙、170.7±22.6妙，Hb光度吸收值分别为1.131±0.44、1.733±0.733，经统计学分析，两组数据都有显著性差异（P〈0.01），几丁糖／海藻酸敷料组明显优于明胶海绵组。结论几丁糖／海藻酸敷料具有较好的止血性能。     

创面复合液体敷料在皮肤创伤中的治疗研究

基于羧甲基壳聚糖的高生物相容性及聚乙烯醇缩丁醛的快速成膜,构建了一种创面复合液体敷料,并对其应用效果进行评价。首先应用羧甲基壳聚糖 (CMC)、聚乙烯醇缩丁醛 (PVB)和乙醇溶液,按照一定的比例,制备创面复合液体敷料。对其防水、透气、阻菌、细胞毒性进行性能研究及安全性评价。然后选择健康成年Sprague-Dawley(SD)大鼠40只,雌雄各半,构建大鼠创面模型,并将含有不同浓度的羧甲基壳聚糖(1.0、10.0、30.0 mg/mL)应用在其创面上,通过日常观察、HE染色等,研究创面复合液体敷料在皮肤创伤中的治疗效果。结果显示创面复合液体敷料上层膜液在1.8～2.3 mm 之间具有很好的防水透气性、阻菌性及生物兼容性。运用在动物模型上可以看到,第7 d含有10.0、30.0 mg/mL CMC组的大鼠创面愈合率分别为65.42%、67.38%,明显高于对照组且存在显著性差异(P< 0.01),14 d后含有10.0、30.0 mg/mL CMC组的大鼠创面愈合率已达到100%。HE 染色的第七天含有10.0、30.0 mg/mL CMC的创面复合液体敷料组中观察到有复层扁平的表皮和真皮的胶原纤维,第12 d组织开始出现内陷结构,含有厚实、粗糙胶原纤维的正常真皮与较薄的胶原纤维水平连接,表皮的复层鳞状上皮远远大于对照组中的三到四层。而且创面连接真皮结缔组织,它的表皮构成非常接近于正常皮肤组织。构建的创面复合液体敷料(10.0 mg/mL CMC)具备良好的防水、透气、阻菌性以及生物兼容性,随着羧甲基壳聚糖浓度的升高,治疗急性创面的效果越好,创面复合液体敷料能够对创面起到早期保护和促进愈合的效果。.     

软聚硅酮银离子敷料应用于烧伤创面的效果评价

文题释义：软聚硅酮银离子敷料：是一种运用Safetac技术制成的高分子有机化合物,从内到外由一层具有自黏性软聚硅酮伤口接触内层,一层包括聚氨酯泡沫、无纺布和高吸收性聚丙烯混合纤维的吸收垫,以及一层透气并防水的外覆薄膜组成,具有抗感染、吸渗性好、透气性好等特性,容易黏附于干燥完整的皮肤表面而不紧贴在湿润创面,能在创面表面形成湿润环境。 烧伤：指由于高温、电流、强辐射或者腐蚀性物质引起的不同程度组织损害,主要指皮肤和/或黏膜,导致组织的缺血缺氧或其他组织器官的免疫功能紊乱,炎症递质释放,最终导致其他组织器官功能的衰竭。 背景：软聚硅酮银离子敷料是一种运用Safetac技术制成的高分子有机化合物,具有抗感染、吸渗性好、透气性好等特性,能为创面愈合提供良好的湿润环境。 目的：评价软聚硅酮银离子敷料修复深Ⅱ度及以下程度烧伤创面的有效性。 方法：应用计算机全面检索知网、维普、万方、中国生物医学文献数据库和PubMed、Embase、Web of Science数据库,选择软聚硅酮银离子敷料修复深Ⅱ度及以下程度烧伤创面的随机对照试验,治疗组为单独软聚硅酮银离子敷料治疗,或软聚硅酮银离子敷料联合常规治疗,或联合其他治疗;对照组为常规治疗,或其他治疗,或安慰剂治疗。对文献进行筛选、信息提取和质量评价后,利用Review Manager 5.3软件进行Meta分析。 结果与结论：①共纳入11篇文献,784例患者,治疗组381例,对照组403例;②Meta分析结果显示：治疗组在第7,14,21天及最后一次测量的烧伤创面愈合率均高于对照组[OR=11.56,95%CI(9.60,13.53),      P < 0.000 01;OR=13.29,95%CI(7.54,19.04),P < 0.000 01;OR=4.10,95%CI(2.28,5.93),P < 0.000 1;OR=1.17,95%CI(0.42,1.93),P =0.002],烧伤创面愈合时间短于对照组[OR=-2.81,95%CI(-3.49,-2.12),P < 0.000 01],烧伤创面疼痛程度低于对照组[OR=-0.38,95%CI(-0.53,-0.24),P < 0.000 01];两组烧伤创面细菌培养阳性率、伤口感染、换药次数、创面治疗费用、不良反应等比较差异均无显著性意义[OR=1.16,95%CI(0.47,2.85),P=0.74;OR=1.44,95%CI(0.47,4.41),P=0.52;OR=-8.04,95%CI(-18.82,2.74),P=0.14;OR=-98.26,95%CI(-272.91,76.40),P=0.27;OR=0.61,95%CI(0.31,1.20),P=0.15];③结果表明,软聚硅酮银离子敷料应用于深Ⅱ度及以下程度的烧伤创面能提高创面愈合率,缩短创面愈合时间,减轻疼痛。 ORCID: 0000-0003-3340-2201(钟淑贤) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

新型敷料在创面修复中的应用与进展

创面是由物理、化学、病原微生物或局部血液供应障碍导致的正常皮肤组织损伤。创面修复是一个日益重要的全球性问题,而敷料在创面修复中占据重要地位,根据创面具体情况选择合适的敷料可以预防创面感染,提高患者治疗过程中的舒适度。然而目前临床中的敷料类型多样、特点各异,如何选择敷料是临床医师面临的难题。本文回顾了多种新型创面敷料的特性与适应证,旨在为临床医师选择适合的创面敷料提供参考。     

传导型敷料Drawtex管理深Ⅱ度烧伤创面的临床疗效

目的:观察传导型敷料Drawtex在深Ⅱ度烧伤创面治疗中的临床疗效。方法:纳入2018年1月至2020年1月北京积水潭医院烧伤科收治的烧伤面积为5%~20%体表总面积（TBSA）的深Ⅱ度烧伤患者200例,随机分为观察组（ n=100）和对照组（ n=100）。两组均给予创面清创换药处理和凡士林油...     

藻酸盐银联合水凝胶敷料对慢性创面愈合的作用

背景：研究发现藻酸盐及水凝胶敷料等均可促进创面愈合,而新型敷料藻酸盐银联合水凝胶敷料,对于难治慢性创面的愈合作用尚不清楚。 目的：观察藻酸盐银联合水凝胶敷料对慢性创面治疗的作用。 方法：选择江苏省人民医院烧伤整形科住院慢性创面患者34例,随机分为2组：治疗组应用藻酸盐银联合水凝胶敷料序贯换药;对照组采用1%磺胺嘧啶银冷霜抹在凡士林纱布上外敷,于治疗后7,10,14,17,21 d进行创面分泌物细菌培养、观察创面愈合情况及速度、药物不良反应、换药时创面痛感、肉芽破坏等情况。 结果与结论：治疗组创面细菌检出率明显低于对照组(P < 0.05)。治疗组创面愈合时间比对照组平均缩短约6 d,创面愈合速度较对照组明显加快(P < 0.05)。两组均无药物不良反应,治疗组创面换药时无明显疼痛感,肉芽组织无明显破坏。提示藻酸盐银联合水凝胶敷料序贯治疗慢性创面具有显著抗菌及促进创面肉芽组织和上皮再生、促进创面愈合的作用,且无不良反应。     

冷宁康敷料对烧伤创面疼痛的治疗

目的探讨新型烧伤敷料治疗Ⅱ度烧伤、减少患者疼痛、促进创面愈合方面的效果。方法对45例Ⅱ度烧伤创面分两组，应用冷宁康和磺胺嘧啶银锌治疗，观察两组创面疼痛情况及愈合时间。结果使用冷宁康组0～Ⅰ级疼痛占95．5％（43／45），对照组中0～Ⅰ级疼痛占17．3％（8／45），两组比较有统计学意义（P〈0．01）。与对照组比较，治疗组浅Ⅱ度创面平均愈合时间缩短2．48d，深Ⅱ度创面平均愈合时间缩短4．61d（P〈0.05）。结论冷宁康不但能促进创面愈合，而且是一种对烧伤创面具有良好止痛作用的外用烧伤敷料。     

In vitro and in vivo evaluation of new PRP antibacterial moisturizing dressings for infectious wound repair

In this study, a solution chitosan fibroin emulsion with added Silver Nanoparticles (AgNPs) was freeze-dried to be the scaffold, and an asymmetric coating was formed on one side. PRP was loaded onto the composite scaffold using a secondary lyophilization technology to prepare the tissue engineering dressings. AgNPs were characterized using a transmission electron microscope. The morphologies of the composite dressing were examined under a scanning electron microscope. The silver content of the dressing was measured by inductively coupled plasma mass spectrometry. The asymmetric wettability of the composite dressing was demonstrated by water contact angle measurement. Relatively high porosity, favourable moisture retention capability and appropriate tensile strength were observed by measuring the physical and mechanical properties. Satisfactory antibacterial properties against various bacteria and microbial isolation performance were observed by the antibacterial effect analysis in vitro. The total protein slow-release property was measured using the BCA assay. Good biocompatibility and lower sensitization were examined both in vitro and in vivo. In addition, the healing effciency of the composite dressing on infected wound were examined in mice infected wound models. Analysis of wound healing rates, bacterial cultures of wound exudate, whole blood cell analysis and histological examination all showed satisfactory results. These results are demonstrated to provide a potential and possible pathway to promote wound tissue repair and regeneration.     

Experimental study of reparative regeneration processes in the wound treated with bioactive dressings

Quantitative and structural functional analysis of granulation tissue cells during treatment with protein-polysaccharide dressing Collahit F was carried out. The preparation effectively cleansed the wound from detritus, prevented secondary infection due to stimulation of the functional activity of macrophages and due to the effect of its antiseptic component (furagin), and stimulated proliferative activity of fibroblasts and granulation tissue microvessels on day 5 of treatment, thus promoting repair processes in the wound.     

Morphofunctional assessment of intestinal wound repair in different age

Anastomoses were formed with a single-row continuous suture in dogs of different age. The course of intestinal wound repair was the least favorable in the youngest dogs, which was apparently due to greater disorders of regional blood flow, high activity of free-radical processes, and pronounced tissue hypoxia at the site of anastomosis, in comparison with the older dogs. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 126, No. 8, pp. 234–236, August, 1998     

The preclinical evaluation of the water vapour transmission rate through burn wound dressings

The control of evaporative water loss, following burn injury, is of major importance to the overall condition of the patient, whether this control is by natural eschar or by a dressing. It is therefore important to preclinically determine the water vapour transmission rate of these dressings, firstly to make comparisons between different materials and secondly to screen prototype materials, under controlled conditions. A preclinical (in vitro) technique is described and the results are given for several commercially available dressings which encompass foam, film and hydrogel material categories.     

高吸型壳聚糖敷料的创面止血及促愈合效果

BACKGROUND: High liquid-absorbing property, high-capacity imbibition property and high antibacterial property of chitosan dressings can be promoted by chemical modification.     

Endotoxin contamination in wound dressings made of natural biomaterials

Contamination by endotoxin of nine kinds of wound dressings made of natural biomaterials (calcium alginate, collagen, chitin, and poly-L-leucine) was examined with the use of water extracts. By applying the Limulus amoebocyte lysate (LAL) test, high concentrations of endotoxin were detected in extracts from three kinds of products made of calcium alginate. These extracts evoked fever in rabbits and induced the release of a proinflammatory (pyrogenic) cytokine, interleukin-6 (IL-6), from human monocytic cells (MM6-CA8). The effects disappeared when the extracts were treated with endotoxin-removing gel column chromatography or with an endotoxin antagonist, B464, confirming that the contaminating pyrogen was endotoxin. A noteworthy finding was that one of the endotoxin-containing extracts showed very weak IL-6-inducibility in human monocytic cells in contrast to its high pyrogenicity to rabbits. The discrepancy could be explained based on differences between humans and rabbits in sensitivity to the endotoxin, because the extract showed higher proinflammatory-cytokine (TNF-alpha)-inducibility in rabbit whole-blood cells (WBCs) than human WBCs. The results suggest that the LAL test is a useful method of detecting endotoxin contamination in wound dressings and the MM6-CA8 assay is a good supplement to the LAL test for evaluating pyrogenicity in humans accurately.     

创面修复“TIME”原则及其意义****◆

背景：随着人们对创面愈合机制研究的深入和创面处理经验的积累,创床的准备对于创面修复的重要性越来越引起人们的高度重视。 目的：全面了解创面愈合的机制,明确影响创面愈合的各种影响因素及其作用。 方法：电子检索中国期刊全文数据库(1994/2011)和 PubMed 数据库(1994/2011),检索词分别为“TIME原则,创面准备,创面愈合”和“TIME principles, wound bed preparation, wound healing”,语言分别设定为中文和英文,分析创面愈合临床应用原则及效果的研究进展。 结果与结论：共检索到文献 498 篇,阅读标题和摘要后,按纳入标准,共纳入22篇。TIME为创面处理过程中创床准备4项原则性的方法的首个英文字母的缩写,即：T指清除创面坏死组织(tissue);I指控制炎症、减轻感染(infection/inflammation);M指保持创面正常的湿度为肉芽组织生长和创面上皮化创造条件(moisture);E 指去除创缘迁移受损的表皮(edge of wound, non migrating)。目前TIME原则作为一个有价值的创面处理指导工具受到临床医生的好评,并应用于临床实践。     

聚乙烯乙醇水化海藻盐泡沫创面敷料封闭负压引流修复糖尿病足溃疡

背景：生物敷料封闭负压引流可促进急、慢性创面愈合。目的：观察采用生物敷料封闭负压引流修复糖尿病足溃疡的临床效果。方法：纳入糖尿病足溃疡患者40例,予以清创或清创植皮后,根据患者意愿选择创面治疗方式,试验组(n=20)进行聚乙烯乙醇水化海藻盐泡沫创面敷料封闭负压引流治疗,对照组(n=20)进行常规伤口换药治疗。修复7 d时,对比两组目测类比评分、血沉、C-反应蛋白水平;对比两组创面愈合时间、治疗终止时的患者满意度及经济费用。结果与结论：试验组目测类比评分、血沉、C-反应蛋白水平均低于对照组(P均< 0.05)。试验组创面愈合时间短于对照组(P < 0.05),患者满意度高于对照组(P < 0.05),两组间经济费用比较差异无显著性意义;试验组未发生局部或全身毒性、过敏等不良反应。表明采用聚乙烯乙醇水化海藻盐泡沫创面敷料封闭负压引流修复糖尿病足溃疡安全有效,可促进创面愈合,降低局部炎症反应。  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程