富血小板纤维蛋白治疗慢性伤口的临床研究

目的:采用自身对照研究评价富血小板纤维蛋白临床治疗慢性伤口的效果。方法:以无抗凝剂的无菌真空试管采集患者自体静脉血10 ml或20 ml,放入离心机内以3 000 r/min速度进行对角离心12 min;取出试管中间凝胶状初级产物,挤压成膜。平摊于伤口上,用透明膜进行固定,1周后揭除透明膜清创换药,记录伤口性状、面积或...     

富血小板纤维蛋白联合泡沫敷料治疗慢性伤口的效果观察

目的 观察富血小板纤维蛋白联合泡沫敷料治疗慢性伤口的临床效果.方法 研究分析2019年2月至2020年1月大同市第三人民医院使用富血小板纤维蛋白联合泡沫敷料治疗的51例慢性伤口患者资料,其中男29例,女22例;年龄18～80岁,平均(52.29±16.11)岁.伤口类型:切口不愈合22例,创伤性溃疡18例,静脉溃疡6例...     

富血小板血浆修复慢性难愈合伤口的应用

【摘要】 目的 探讨富血小板血浆(PRP)修复慢性难愈合伤口的疗效。方法 分析从2010年10月至2012年3月,32例接受来源于自体的富含血小板血浆进行治疗的难愈合伤口患者。抽取患者静脉血30 mL,离心,与氯化钙和凝血酶混合后制成PRP凝胶敷于创面,凡士林纱布填塞,医用薄膜封闭创面,每7天更换1次,3次治疗为一疗程。评估治疗后伤口变化情况以及首次彻底清创后创面(治疗前V1)和2个月(治疗后V2)随访时创面体积。结果 32例患者使用3次PRP凝胶后,患者伤口均明显缩小,组织色泽红润血供良好,无明显渗液和脓液。治疗前测量创面体积(V1)为9.5±4.7 mL,治疗后2月时创面体积(V2)为1.7±0.9 mL,差异有统计学意义(P<0.05);治愈率31.2%,显效率93.8%。结论 富血小板血浆修复慢性难愈合伤口是一种有效、实用的治疗方法。     

2例自体富血小板血浆治疗难愈合伤口的护理

对两例慢性溃疡患者采用清创,用自体富血小板血浆敷于创面,伤口愈合较快,疗效满意.提示富血小板血浆具有促进伤口愈合的作用,时于久治不愈的慢性溃疡,富血小板血浆敷创面是一种较其它治疗方式更有效的方法.     

富血小板血浆治疗下肢慢性难愈合伤口47例随访研究

目的 探讨富血小板血浆(platelet-rich plasma,PRP)对下肢慢性难愈合伤口的修复作用. 方法 2007年5月-2007年11月,采用PRP注射治疗下肢慢性难愈合伤口47例.男41例,女6例;年龄15～68岁,平均43.2岁.原发疾病:胫腓骨骨折20例,跟骨骨折4例,跖骨骨折1例,下肢多发开放性骨折3例,胫骨骨髓炎10例,股骨骨髓炎1例,足踝部软组织损伤4例,截肢术后感染2例,足部矫形术后感染及跟腱修补术后感染各1例.外院治疗后2～4个月创口未愈合转入合并骨折未愈合23例,细菌培养结果 阳性38例.患者予2次清创加自体PRP伤口内注射,每次间隔2个月. 结果 患者均于首次注射PRP后获随访,随访时间4个月.首次注射PRP2个月后,34例伤口明显缩小,坏死组织及脓苔清除,组织色泽健康,血供良好,外露骨或肌肉组织被新牛肉芽组织覆盖.4个月随访时,无肌肉和骨组织外露患者,创面覆盖率79.3%4±18.O%,总治愈率29.8%.治疗前创口体积(11.8±5.6)mL,治疗后为(2.5±2.7)mL,创口体积缩小(9.3±4.9)mL,治疗前后创口体积比较差异有统计学意义(P＜0.05).术前23例合并骨折未愈合者,随访4个月时骨折完全愈合9例,骨痂生长明显增多12例,无明显改变2例,均无骨髓炎征象加重.细菌培养阳性结果 15例. 结论 PRP能有效促进软组织缺损修复,加速下肢慢性难愈合伤口愈合.     

富血小板血浆促进慢性难愈合伤口修复的研究进展

富血小板血浆（platelet-rich plasma,PRP）是一种血小板浓缩物,以离心的方法从自体血中提取。PRP中的血小板经激活后能释放出大量高浓度的生长因子,如血小板源性生长因子（platelet—derived growth factor,PDGF）、转化生长因子-β（transforming growthfactor—β,TGF—β）、     

富血小板纤维蛋白在慢性难愈性创面中的临床应用

目的 探讨富血小板纤维蛋白在慢性难愈性创面临床应用中的疗效和特点.方法 选取2018年3月～2019年9月于本院诊治的慢性难愈性创面病人共105例,回顾性分析所有病人病历资料,对病人疗效进行统计学分析.男性44例,女性61例.年龄2～76岁,平均42.6岁.病程3周～6个月.所有病人均接受富血小板纤维蛋白治疗,治疗时间...     

富血小板纤维蛋白填充治疗下肢骨外露创面效果观察

目的观察采用富血小板纤维蛋白填充治疗下肢创伤手术后遗留骨外露创面的临床效果。方法回顾性分析自2017-05—2017-11采用富血小板纤维蛋白填充治疗的7例下肢创伤手术后遗留的骨外露创面,于患者肘正中静脉采血制备富血小板纤维蛋白,将所制备的富血小板纤维蛋白凝胶填充至创腔内。结果本组采用富血小板纤维蛋白凝胶填充治疗1～3次。术后随访1～6个月,创面愈合良好,未出现感染。1例左足踝部位治疗区域与周围皮肤色差明显,其余患者创区与周围皮肤无明显差别。创面愈合后皮肤质地柔软,皮温觉、触觉、痛觉不同程度恢复。术后2个月踝关节无异常,左小腿下段无压痛。结论采用富血小板纤维蛋白填充治疗下肢创伤手术后遗留的骨外露创面效果满意,富血小板纤维蛋白制备过程简单,降低了外源混入后的感染风险及免疫反应风险,大量的生长因子可加快组织再生、创面愈合。     

富血小板纤维蛋白促进创伤修复的研究进展

软组织和硬组织的创伤修复是由细胞内、外多种物质介导,调节信号蛋白的活动.虽然对整个过程的机制目前尚不十分清楚[1],但血小板在促进创伤修复中的重要作用已经得到证实[2].自Whitman等[3]首次采用浓缩血小板取代纤维蛋白胶来改善创伤愈合以来,制备浓缩血小板的技术一直在不断地发展和进步.研究血小板浓缩物用于临床研究的效果,近年来一直存有争议[4-5].     

富血小板纤维蛋白在整形外科的应用进展

富血小板纤维蛋白(Platelet-rich fibrin,PRF)是新一代的血小板浓缩制品,其制备简便,材料完全来源于自身血液,同时富含各种生长因子和细胞因子,对于加快组织修复,促进组织再生有一定作用。虽然PRF受到越来越多的关注,在口腔科、骨科等有了诸多研究报道,但其在整形外科领域的应用仍较少。本文综述近年来相关文献,介绍PRF的制备方法及其衍生物,并对PRF在整形外科中的应用报道进行总结。     

纤维蛋白胶在实验性皮肤损伤愈合中的作用

纤维蛋白胶是一种理想的组织粘合剂和止血剂,它具有为成纤维细胞生长提供骨架、刺激修复细胞生长和封闭受损血管等作用.本文观察了它在动物皮肤损伤愈合模型中的作用.     

The maximization of wound healing with fibrin glue

Our experience in the application of so-called fibrin glue in 304 patients submitted to a variety of operations in plastic surgery from January 1981 to May 1982 is presented. The results seem to be much better than without this substance and afford greater comfort for the patient. Addition of factor XIII seems to be unnecessary.     

循证护理实践模式及应用启示

结合国内外循证护理实践研究最新进展,在前期研究的基础上,对重要的9个循证护理实践模式进行比较评价和应用阐释,并提出具体评价标准,以期为循证护理相关教育、研究和临床实践提供有益启示。     

Thrombin as important factor for cutaneous wound healing: Comparison of fibrin biomatrices in vitro and in a rat excisional wound healing model

Fibrin biomatrices have been used for many years for hemostasis and sealing and are a well‐established surgical tool. The objective of the present study was to compare two commercially available fibrin biomatrices regarding the effect of their thrombin concentration on keratinocytes and wound healing in vitro and in vivo. Keratinocytes showed significant differences in adhesion, viability, and morphology in the presence of the fibrin matrices in vitro. A high thrombin concentration (800–1,200 IU/mL) caused deteriorated cell compatibility. By using a thrombin inhibitor, those differences could be reversed. In a rat excisional wound healing model, we observed more rapid wound closure and less wound severity in wounds treated with a fibrin matrix containing a lower concentration of thrombin (4 IU/mL). Furthermore, fewer new functional vessels and a lower level of vascular endothelial growth factor were measured in wounds after 7 days treated with the matrix with higher thrombin concentration. These in vivo results may be partially explained by the in vitro biocompatibility data. Additionally, results show that low thrombin biomatrices were degraded faster than the high thrombin material. Hence, we conclude that the composition of fibrin biomatrices influences keratinocytes and therefore has an impact on wound healing.     

证据应用在循证护理实践的研究现状

对护理实践中证据应用的历史、背景、促进措施、研究设计和效果评价、模式、国内案例、面临的挑战及哲学思考进行综述。认为循证护理实践在横向扩展应用领域的同时,更需要从已有的经验证据上升和反思,从哲学层面深入探索符合我国护理情景的证据应用概念框架,以促进我国循证护理实践向纵深发展。     

Moist wound healing: a concept that changed our practice

Winter's seminal paper from 1962 showed that a moist wound environment accelerates healing. Since then, different types of dressings have been developed based on this concept. This paper describes their background and correct usage.     

Preface: evidence-based practice guideline for the treatment of chronic kidney disease

Guidelines

Preface: evidence-based practice guideline for the treatment of chronic kidney disease     

A PEGylated fibrin hydrogel‐based antimicrobial wound dressing controls infection without impeding wound healing

Combat injuries are associated with a high incidence of infection, and there is a continuing need for improved approaches to control infection and promote wound healing. Due to the possible local and systemic adverse effects of standard 1% cream formulation (Silvadene), we had previously developed a polyethylene glycol (PEGylated) fibrin hydrogel (FPEG)‐based wound dressing for the controlled delivery of silver sulfadiazine (SSD) entrapped in chitosan microspheres (CSM). In this study, we have evaluated the antimicrobial and wound healing efficacy of SSD‐CSM‐FPEG using a full‐thickness porcine wound infected with Pseudomonas aeruginosa. Infected wounds treated with a one‐time application of the SSD‐CSM‐FPEG wound dressing demonstrated significantly reduced bacterial bioburden over time (99·99% of reduction by day 11; P < 0·05) compared with all the other treatment groups. The epithelial thickness and granulation of the wound bed was significantly better on day 7 (150·9 ± 13·12 µm), when compared with other treatment groups. Overall, our findings demonstrate that the SSD‐CSM‐FPEG wound dressing effectively controls P. aeruginosa infection and promotes wound healing by providing a favourable environment that induces neovascularisation. Collectively, sustained release of SSD using fibrin hydrogel exhibited enhanced benefits when compared with the currently available SSD treatment, and this may have significant implications in the bacterial reduction of infected wounds in military and civilian populations.     

Regenerating matrix-based therapy for chronic wound healing: a prospective within-subject pilot study

The aim of this study was to determine whether a skin-specific bioengineered regenerating agent (RGTA) heparan sulphate mimetic (CACIPLIQ20) improves chronic wound healing. The design of this article is a prospective within-subject study. The setting was an urban hospital. Patients were 16 African-American individuals (mean age 42 years) with 22 wounds (mean duration 2.5 years) because of either pressure, diabetic, vascular or burn wounds. Two participants each were lost to follow-up or removed because of poor compliance, resulting in 18 wounds analysed. Sterile gauze was soaked with CACIPLIQ20 saline solution, placed on the wound for 5 min, then removed twice weekly for 4 weeks. Wounds were otherwise treated according to the standard of care. Twenty-two percent of wounds fully healed during the treatment period. Wounds showed a 15.2-18.1% decrease in wound size as measured by the vision engineering research group (VERG) digital wound measurement system and total PUSH scores, respectively, at 4 weeks (P = 0.014 and P = 0.003). At 8 weeks there was an 18-26% reduction in wound size (P = 0.04) in the remaining patients. Wound-related pain measured by the visual analogue pain scale and the wound pain scale declined 60% (P = 0.024) and 70% (P = 0.001), respectively. Patient and clinician satisfaction remained positive throughout the treatment period. It is concluded that treatment with CACIPLIQ20 significantly improved wound-related pain and may facilitate wound healing. Patient and clinician satisfaction remained high throughout the trial.