表皮生长因子对大鼠深Ⅱ度烧伤创面愈合的影响

目的　进一步观察重组人表皮生长因子 (rhEGF)对深Ⅱ度烧伤创面愈合的促进作用。方法　采用大鼠深Ⅱ度烫伤模型 (以下称烧伤 ) ,创面分别外用rhEGF、肝素加rhEGF及等渗盐水。比较不同方式处理创面后的愈合时间 ,测定创面愈合率、创面含水量、羟脯氨酸 (OHP)含量及Ⅰ /Ⅲ型胶原比例 ,进行细胞DNA周期分析和组织学检查。　结果　外用rhEGF可使烧伤创面愈合时间缩短 2d,增加创面OHP含量 (P <0.0 5),降低Ⅰ /Ⅲ型胶原比例 (P <0.0 5),促进肉芽组织形成 ,加速细胞DNA复制 (P <0.0 5 )。加用肝素后可使创面愈合时间进一步缩短 2d,促进肉芽组织生长。伤后第 7天用药各组间比较 ,差异无显著性意义 (P >0.0 5)。　结论　外用rhEGF能明显促进深Ⅱ度烧伤创面愈合 ,加用肝素后效果更加显著 ,但早期使用rhEGF效果不明显     

类肝素对大鼠深Ⅱ度烫伤创面愈合的影响

目的探讨深Ⅱ度烧伤创面早期加深而延迟愈合的机理。方法采用大鼠深Ⅱ度烫伤模型,创面外用类肝素软膏,观察其对大鼠深Ⅱ度烫伤早期创面病理变化和创面愈合的影响,并测定了烧伤创面含水量,血浆和烧伤创面抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白降解产物(FDP)含量、烧伤创面羟脯氨酸含量、Ⅰ/Ⅲ型胶原比例、真皮细胞增殖周期及创面愈合时间。结果创面外用类肝素可以降低烧伤创面水肿程度,增加血浆AT-重活性,增加烧伤创面中FDP含量及羟脯氨酸含量,促使Ⅰ/Ⅲ型胶原比例降低,增加真皮细胞中DNA合成,减轻烧伤创面早期加深,缩短大鼠深Ⅱ度烫伤创面愈合时间。结论类肝素具有促进大鼠深Ⅱ度烫伤创面愈合的作用。     

重组人表皮生长因子对各类皮肤创面的疗效观察

目的:观察重组人表皮生长因子(rhEGF)对各类皮肤创面的治疗作用。方法:应用重组人表皮生长因子(rhEGF)治疗各种烧伤创面及术后创面,观察不同创面的愈合时间、愈合质量、不良反应等指标。结果:共治疗75例,总有效率100%;与对照组相比,普遍愈合时间缩短(P<0.01);创面再生上皮质量较好,瘢痕轻或无;所有病例均无不良反应。结论:在各类皮肤创面的治疗中应用rhEGF,能缩短愈合时间,提高愈合质量。保湿技术可延长rhEGF的作用时间。     

白芨胶载外源性rhEGF对创面中羟脯氨酸含量的影响

目的 观察中药白芨胶(BSG)作为外源性重组人表皮生长因子(rhEGF)的载体,在兔背部的创面愈合过程中对羟脯氨酸(HYP)含量的影响,并探讨其机制.方法 选取健康家兔40只,体重2.5～3.0 kg,雌雄各半.随机分为盐水对照(SW)、BSG、rhEGF、BSG+rhEGF四组,于脊柱的两侧其正中旁开2.0 cm处手术制作皮肤全层缺损创面各3个,面积约2.0 cm×2.0 cm.分别用浸透上述四种液体的纱布外敷创面,隔日换药1次.于外敷后第3、5、7、10天取材,行HYP含量的测定.结果 四组的HYP含量于外敷后第3天均较低,以后逐渐递增,至第10天达较高水平.在同一时间段上,BSG+rhEGF组的HYP含量显著高于其余三组(P＜0.05),BSG组略高于rhEGF组(P＞0.05),但三组均显著高于SW组(P＜0.05).结论 BSG+rhEGF能促进创面中HYP合成的增加,从而缩短了创面的愈合时间,提高了愈合质量.     

重组人表皮生长因子促进兔创面愈合及其量效关系的实验研究

目的：观察重组人表皮生长因子（rh-EGF）对兔皮肤创面愈合的促进作用及其量效关系。方法：制作兔子背部创伤模型,20只兔子背部制作共100个创面,这些创面分为实验组和对照组,实验组包括：低剂量rh-EGF（0.5μg/g）组、中剂量rh-EGF（10μg/g）组、高剂量rh-EGF（100μg/g）组,对照组包括：生理盐水组和EGF基质组,观察五组的大体形态和组织学改变、创面愈合时间和愈合率,测定创面羟脯氨酸（OHP）含量。结果：rh-EGF低剂量组、中剂量组、高剂量组、盐水组和EGF基质组的愈合时间分别为（14.7±0.67）天,（12.9±0.92）天,（11.8±0.99）天,（15.8±0.90）天,（15.5±0.85）天,P〈0.05）。组织学检查可见经rh-EGF高剂量组作用的创面肉芽组织生长活跃,创面的再上皮化迅速。rh-EGF高剂量组的创面中羟脯氨酸含量也最高。结论：rh-EGF对皮肤创面愈合有促进作用,并存在一定的量效关系。以高剂量的rh-EGF（100μg/g）促进作用最大。     

重组人表皮生长因子对大鼠皮肤生长的影响

既往研究表明，利用基因工程技术生产的重组人表皮生长因子(rhEGF)对多种组织来源的上皮和表皮细胞有较强的促有丝分裂活性，能刺激皮肤表皮细胞的增殖，促进各种皮肤创面愈合。本研究旨在观察rhEGF促进大鼠皮肤生长的作用及其量效关系，探讨促进皮肤生长的适宜剂量。     

类肝素对大鼠深Ⅱ度烫伤创面愈合的影响

目的探讨深Ⅱ度烧伤创面早期加深而延迟愈合的机理。方法采用大鼠深Ⅱ度烫伤模型，创面外用类肝素软膏，观察其对大鼠深Ⅱ度烫伤早期创面病理变化和创面愈合的影响，并测定了烧伤创面含水量，血浆和烧伤创面抗凝血酶Ⅲ（ＡＴ－Ⅲ）、纤维蛋白降解产物（ＦＤＰ）含量、烧伤创面羟脯氨酸含量、Ⅰ／Ⅲ型胶原比例、真皮细胞增殖周期及创面愈合时间。结果创面外用类肝素可以降低烧伤创面水肿程度，增加血浆ＡＴ－Ⅲ活性，增加烧伤创面中ＦＤＰ含量及羟脯氨酸含量，促使Ⅰ／Ⅲ型胶原比例降低，增加真皮细胞中ＤＮＡ合成，减轻烧伤创面早期加深，缩短大鼠深Ⅱ度烫伤创面愈合时间。结论类肝素具有促进大鼠深Ⅱ度烫伤创面愈合的作用。     

烧伤创面应用生长因子后的DNA分析

将基因重组的人表皮细胞生长因子(rh-EGF)、酸性成纤维细胞生长因子(r-aFGF)、碱性成纤维细胞生长因子(r-bFGF)和牛脑提取液(bBE)外用于烧伤创面,旨在探讨皮肤组织和细胞 DNA 的含量及周期变化。实验结果显示:烧伤创面经应用 rh-EGF,r-aFGF,r-bFGF 和 bBE 后第5天与生理盐水组(NS)相比,创面愈合率、表皮细胞和全厚层皮肤组织的 DNA 含量均高于 NS 组(P<0.01);全厚层皮肤 DNA 的流式细胞仪分析表明,应用生长因子各组的 S 期细胞数百分比均高于 NS 组(P<0.01),细胞分裂增殖旺盛,G 期细胞不断进入 S 期,使 S 期细胞数增加,DNA 的合成和含量增加。提示:烧伤创面外用细胞生长因子可促进表皮细胞的增殖,加速创面的愈合。     

不同取皮方法、创面不同处理对烧伤手术供皮区愈合影响的研究

目的回顾性研究了我院近5年来烧伤病人供皮区取皮方法的改进和供皮区创面用药的变化与供皮区创面愈合时间的变化。方法总结了我院自2002年以来收治的烧伤住院手术病人1523例,按辊轴手取刀与电动取皮刀,比较了取皮创面基底的均匀程度及创面愈合后边缘是否整齐;创面应用重组人表皮生长因子(rhEGF)与创面单纯应用油纱布在创面愈合时间的对比。结果电动取皮刀在供皮区创面取皮时所取的供皮厚度明显均匀,创面愈合后边缘整齐;应用重组人表皮生长因子(rhEGF)的创面愈合时间比单纯应用油纱布的创面愈合时间明显缩短。结论应用电动取皮刀取皮,可以使皮片厚度均匀,创面愈合后边缘整齐;创面应用rhEGF,能明显加快创面愈合,有利于烧伤创面的愈合。     

白芨胶载外源性rhEGF对伤口愈合影响的组织学研究

目的:探讨中药白芨胶(Bletillastriatagelatin,BSG)作为外源性重组人表皮生长因子(RecombinantHumanEpidermalgrowthfactor,rhEGF)的载体对兔背部伤口愈合的影响及其机制。方法:选取健康家兔40只,体重2.5～3kg,雌雄各半。距脊柱正中旁开2cm处做皮肤全层切口,面积约2cm×2cm,左右各3个。用已配置好的药液浸透双层纱布外敷伤口,每日换药一次。取材后进行伤口愈合时间、伤口愈合率、HE和Masson染色后的光镜组织学观察。结果:BSG rhEGF的伤口愈合率和伤口愈合时间与SW组(Salinewater,SW)、BSG组和rhEGF组比较均有显著差异(P<0.05)。HE和Masson染色后光镜组织学观察发现BSG rhEGF能促进炎症细胞渗出,肉芽组织、新生毛细血管和胶原纤维形成。结论:BSG载外源性rhEGF通过促进肉芽组织、新生毛细血管和胶原纤维的生成进而促进伤口愈合,其作用优于单用白芨和单用表皮生长因子。     

表皮细胞生长因子与碱性成纤维细胞生长因子促进创面修复效应的比较性研究

目的 采用小型猪背部创伤模型,定量研究与比较重组人表皮细胞生长因子与重组人碱性成纤维细胞生长因子的促修复效应与作用机制。方法 以创伤模型制作器切割小型猪背部皮肤,造成典型全层皮肤损伤。将１６只小型猪背部的１６０个创面分成两大组,分别以三种不同剂量的ｒｈＥＧＦ（５０,１０及０．５μｇ／创面）和ｒｈＦＧＦ（１５０、９０及３０Ｕ／ｃｍ＾２创面）治疗,每组同时各设溶媒为阴性对照。以伤腔容积与创面愈合面积,     

应用表皮生长因子治疗深Ⅱ度烧伤创面的远期临床疗效观察

目的　观察重组人表皮生长因子 (rhEGF)用于深Ⅱ度烧伤创面治疗的远期疗效及安全性。　方法　对 37例烧伤患者进行随机、双盲、同体对照实验 ,每例患者选择一块深Ⅱ度烧伤创面 ,并将其分为面积相近的两部分 ,于伤后第 1天开始分别用单纯等渗盐水 (对照组 )和含rhEGF的等渗盐水 (治疗组 )进行换药治疗。创面愈合后 1、4年时 ,对各患者进行院外随访 ,采用改良温哥华瘢痕测量法 ,评价上述受试创面愈合后的瘢痕指数 (SI)。　结果　 1年后随访时 ,治疗组SI为 7.19± 1.6 7,明显小于对照组 8.92± 1.78(P <0 .0 1) ;4年后随访时 ,治疗组SI为 6 .12± 1.5 4 ,明显小于对照组 8.0 9± 1.81(P <0 .0 1)。所有受试创面均无肿瘤形成、癌变等并发症发生。　结论　外用rhEGF治疗深Ⅱ度烧伤创面 ,能明显减少后期瘢痕的形成 ,远期疗效和安全性较好。     

重组人表皮生长因子凝胶（易孚）在压疮创面床准备中的临床观察

目的：探讨重组人表皮生长因子（rhEGF）凝胶（易孚）在手术修复复杂压疮（Ⅲ期与IV期）前期创面床准备阶段的疗效。方法：将80例压疮患者随机分为治疗组及对照组,各组40例,在常规清创及生理盐水冲洗创面后,治疗组将重组人表皮生长因子凝胶（易孚）置于湿纱布上;对照组用碘伏纱布湿敷创面,换药均为1次/天。观察创面床改善情况。结果：实验组的创面床改善时间与手术后恢复时间较对照组明显缩短,差异有显著性。结论：重组人表皮生长因子凝胶（易孚）在复杂压疮创面床准备阶段疗效显著,可促进肉芽组织生长,炎症消失,有利于创面的内源性愈合并增加后续治疗的有效性。     

重组人表皮细胞生长因子在慢性溃疡创面中的应用

目的　观察重组人表皮细胞生长因子 (rh EGF)对慢性溃疡创面愈合的影响。方法　 1999年 10月～ 2 0 0 1年 1月在局部清创后随机对 2 6例患者的慢性溃疡创面 (3cm× 3cm～ 5 cm× 8cm )作为治疗组 ,用rh EGF喷雾剂以 40 0 U / 10 cm2 进行局部喷涂 ,无菌敷料覆盖 ;同期随机对另 2 6例慢性溃疡创面 (2 .5 cm×3.0 cm～ 4.0 cm× 6 .5 cm )用 0 .9%生理盐水进行局部湿敷作为对照组 ,观察创面愈合时间、创面局部及全身反应情况。结果　治疗组中创面不适感消失早 ,脓性分泌物少 ,肉芽组织生长快 ,无过度增生现象。溃疡创面愈合时间治疗组较对照组缩短 7～ 10天 ,经统计学处理 ,有显著性差异 (P<0 .0 1)。结论　 rh EGF有明显促进慢性溃疡创面愈合的作用 ,且愈合时间短、质量好     

Nanotechnology promotes the full‐thickness diabetic wound healing effect of recombinant human epidermal growth factor in diabetic rats

We utilized a modified double‐emulsion method with poly(lactic‐co‐glycolic acid) as the carrier to prepare recombinant human epidermal growth factor (rhEGF) nanoparticles. The morphology of the nanoparticles was detected by a transmission electron microscope. The particle size distribution was measured by a laser analyzer with a zeta potential meter. Enzyme‐linked immunosorbent assays were performed to determine the rhEGF encapsulation efficiency and release model, and the proliferation of the mouse fibroblasts was analyzed by the MTT method. Diabetic rats with full‐thickness wounds were divided into four groups according to different treatments: rhEGF nanoparticles, rhEGF stock solution, empty nanoparticles, and phosphate‐buffered saline. Photographs were taken after the treatments to calculate the wound healing rates, and the granulation tissue of the wounds was sampled for pathologic slides. Proliferating cell nuclear antigen was assayed by immunohistochemistry. Our results showed that the rhEGF nanoparticles were around 193.5 nm (diameter), and the particle size distribution was uniform and dispersible. The encapsulation efficiency was 85.6% and rhEGF release lasted 24 hours. Compared with other groups, the rhEGF nanoparticles promoted the highest level of fibroblast proliferation, and this group showed the fastest healing rate. The number of proliferating cell nuclear antigen positive cells in the rhEGF nanoparticles group was higher than the other groups. We concluded that controlled release of rhEGF encapsulated in the nanoparticles enhanced rhEGF effects to stimulate cell proliferation and shorten the wound healing time.     

表皮生长因子与碱性成纤维细胞生长因子促进创面修复的比较研究

目的　比较重组人表皮生长因子 (rhEGF)与重组人碱性成纤维细胞生长因子 (rhbFGF)促进创面修复的效应及其作用机制。　方法　选用 12只大耳白兔 2 4只耳上的 72个创面 ,随机分为rhEGF(10 μg/cm2 )治疗组、rhbFGF(10 0AU/cm2 )治疗组和对照组 (涂以 1%磺胺嘧啶银霜 )。观察创面的愈合情况 ,分别取不同时段的标本进行病理学、电镜检查 ,并通过原位杂交检测标本中整合素 β1mRNA的表达情况。　结果　两治疗组整合素 β1mRNA的表达明显高于对照组 ;创面修复的时间明显比对照组快 ,且修复质量较对照组高 (P <0 .0 5 ) ;成纤维细胞数和毛细血管胚芽数与对照组比较差异有显著性意义 (P <0 .0 5 )。　结论　rhEGF、rhbFGF均能提高创面修复质量 ,在修复早、中期使用rhbFGF能促进肉芽组织生长 ;中、晚期使用rhEGF能加速创面的再上皮化。根据时效 ,联合应用rhEGF、rhbFGF可获得最佳效价比。     

L-arginine improves wound healing after trauma-hemorrhage by increasing collagen synthesis

BACKGROUND: Several studies indicate impaired wound healing after trauma and shock. Wound immune cell dysfunction seems to be responsible for altered wound healing after trauma-hemorrhage (T-H). In this respect, administration of the amino acid L-arginine normalized wound immune cell function under those conditions. It remains unknown, however, whether L-arginine improves impaired wound healing after T-H. METHODS: To study this, male C3H/HeN mice were subjected to a midline laparotomy (i.e., soft tissue trauma induced), and polyvinyl sponges were implanted subcutaneously at the wound site before hemorrhage (35 +/- 5 mm Hg for 90 minutes) or were subjected to sham operation. During resuscitation, mice received 300 mg/kg body weight L-arginine or saline (vehicle). Seven days thereafter, hydroxyproline (OHP), a metabolite of collagen synthesis, was measured in the wound fluid using high-performance liquid chromatography. Collagen types I and III were determined in the wound by Western blot analysis. In addition, wound breaking strength was measured 10 days after T-H or sham operation. RESULTS: The results indicate that OHP was significantly decreased in T-H mice. L-arginine, however, restored depressed OHP in the wound fluid in the T-H animals. Similarly, L-arginine treatment prevented a significant depression of collagen I synthesis after T-H. Collagen III was not significantly affected by T-H or L-arginine. Most important, L-arginine increased maximal wound breaking strength after severe blood loss. Therefore, L-arginine improves wound healing after T-H by increasing collagen synthesis. CONCLUSION: Because L-arginine improves wound healing, the results suggest that L-arginine might represent a novel and useful adjunct to fluid resuscitation for decreasing wound complications after trauma and severe blood loss.     

Use of a lyophilized bovine collagen matrix in postoperative wound healing.

BACKGROUND: Immediate reconstruction is the preferred approach to the management of defects following Mohs micrographic surgery. In a minority of patients, however, reconstruction is contraindicated, and a long-term biological dressing that stimulates wound healing and minimizes wound care is desirable. OBJECTIVE: We wanted to assess the utility of a lyophilized, type I bovine collagen matrix (SkinTemp) in wound care and wound healing following Mohs micrographic surgery. METHODS: Fifteen patients were treated with a bovine collagen matrix following Mohs micrographic surgery. Study wounds were evaluated for time to complete granulation, time to complete epithelialization, and adverse reactions including infection and allergy. The time to complete healing (granulation and epithelialization) for this group was compared to 15 size- and site-matched surgical defects. RESULTS: The use of bovine collagen matrix provided more rapid wound healing than traditional second intention healing at all anatomic sites studied. The time to complete healing averaged 6.1 weeks with bovine collagen matrix versus 9.4 weeks for the control group. Use of bovine collagen matrix required an average of 3.0 dressing changes weekly compared to 7.0 changes weekly in the control group. There were no wound infections or allergic reactions to it. CONCLUSIONS: A Type I bovine collagen matrix provided a safe, readily available alternative to traditional methods of second intention healing. It minimized wound care while reducing the time for complete healing. A larger study should be performed to confirm the results of this pilot study.