A liposome hydrogel with polyvinyl-pyrrolidone iodine in the local treatment of partial-thickness burn wounds

Local treatment of burn injuries with conventional anti-infective preparations does not provide the moist environment that promotes fast wound healing. In a randomized controlled trial the effects of liposome polyvinyl-pyrrolidone-iodine (PVP-I) hydrogel, a novel formulation of PVP-I in a liposome hydrogel with high water-binding capacity, were investigated in 43 patients with partial-thickness burn wounds in an intraindividual comparison with a conventional silver-sulfadiazine cream. Treatment with liposome PVP-I hydrogel resulted in significantly faster complete healing of the burn wounds compared with silver-sulfadiazine cream (9.9 +/- 4.5 days versus 11.3 +/- 4.9; P < 0.015). The cosmetic result (smoothness, elasticity, appearance) was rated as excellent for 37.0% of study wounds with liposome PVP-I hydrogel compared with 13.0% of wounds treated with silver-sulfadiazine cream. Local tolerability was good; handling and change of dressing were rated as easy. Local treatment with liposome PVP-I hydrogel thus provides fast wound healing with a favorable cosmetic result.     

PVP-iodine in hydrosomes and hydrogel--a novel concept in wound therapy leads to enhanced epithelialization and reduced loss of skin grafts

BACKGROUND: Moist wound treatment improves healing at a possibly increased risk of bacterial infection and many local antiseptics impair healing. A moist treatment modality with efficient antimicrobial activity would be desirable. METHODS: In this monocentric, randomized, observer blinded, phase III study, a new hydrosome polyvinyl-pyrrolidone (PVP)-iodine preparation in hydrogel containing iodine in a 3% concentration (Repithel) was investigated for its effect on epithelialization in patients receiving meshed skin grafts. Grafts of 167 patients (donor site defects, burn wounds, or chronic defects) were dressed either with Repithel (n=83) covered with a gauze (Jelonet), or Jelonet-gauze only (n=84) until healing. RESULTS: Grafts receiving Repithel healed significantly earlier (9.4 days versus 12.4 days; p<0.0001) and faster than controls as measured by neo-epithelialization of mesh holes between days 7 and 11 (91.2+/-22.8% versus 82.3%+/-28.6, p<0.0001). A subgroup analysis showed that the effects on grafted burn wounds (p=0.0042) and chronic defects (p<0.0001) was more significant than on donor sites. Also a higher take rate of grafts (p=0.0053) and a reduced loss of grafts was observed with Repithel treatment (8 grafts versus 20 grafts) (p=0.0063, respectively). Smokers had improved graft take (p=0.0069) and higher rate of epithelialization (p=0.0040) compared to smokers of the control group. CONCLUSIONS: The results demonstrate significant clinical advantages of Repithel. This new local wound healing drug combines antisepsis and wound moisture efficiently resulting in significantly enhanced epithelialization, decreased transplant losses, and significantly improved healing especially in smokers.     

An investigation on burn wound healing in rats with chitosan gel formulation containing epidermal growth factor

Various studies have shown that chitosan is effective in promoting wound healing. In this study, we aimed to develop an effective chitosan gel formulation containing epidermal growth factor (EGF), and to determine the effect on healing of second-degree burn wounds in rats. Ten micrograms per millilitre EGF in 2% chitosan gel was prepared. In an in vitro study to investigate release of EGF from the formulations, the release rate was 97.3% after 24 h. In in vivo studies, animals were divided into six groups as follows: silver sulfadiazine [Silverdin cream (SIL)], chitosan gel with and without EGF (EJ, J), EGF solution (ES) and untreated control groups [unburned (S) and untreated (Y) rats] applied groups, respectively. A uniform deep second-degree burn of the backskin was performed with water heated to 94+/-1 degrees C during a 15-s exposure. The EGF formulations were repeatedly applied on the burned areas with a dose of 0.160 microg/cm2 for 14 days (one application per day). Healing of the wounds was evaluated immunohistochemically, histochemically and histologically on the tissue samples. When the results were evaluated immunohistochemically, there were significant increases in cell proliferation observed in the EGF containing gel applied group (p<0.001). The histochemical results showed that the epithelization rate in the EJ group was the highest compared to the ES group results (p<0.001). The histological results indicated and supported these findings. It can be concluded that a better and faster epithelization was observed in the EJ group compared to the other groups.     

Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy

The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area <40% were simple randomised to treat with nanocrystalline silver nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine.     

硝酸银软膏对Ⅱ度烧伤创面治疗作用的多中心临床研究

目的观察硝酸银(AgNO3)软膏对浅Ⅱ、深Ⅱ度烧伤创面的治疗效果,并评价其药物不良反应。方法选择80例浅Ⅱ度和40例深Ⅱ度烧伤患者,进行多中心、随机、阳性药物平行对照和同体试验研究(共4个中心,每个中心30例)。将患者创面按用药不同分为AgNO3组和磺胺嘧啶银(SD-Ag)组,观察各组创面完全愈合时间、指定时相点下创面愈合率、创面细菌培养情况、药物疗效和安全性、药物对创面的刺激性等。结果浅Ⅱ度创面:AgNO3组完全愈合时间为(9．5±2．7)d, SD-Ag组为(10．8±3．4)d,用药后7 d创面愈合率分别为(77．9±20．5)％及(67．3±22．6)％;深Ⅱ度创面:AgNO3组完全愈合时间为(21．5±4．8)d,SD-Ag组为(23．3±6,4)d,用药后20 d创面愈合率分别为(86．6±15．9)％及(78．5±17．7)％。同等深度烧伤创面上述各项数据两组间比较,差异均有统计学意义(P<0．01)。同等深度烧伤创面AgNO3组与SD-Ag组比较,具有同样明显的杀菌作用,但前者对创面的刺激性更小。结论AgNO3软膏是一种可用于浅Ⅱ、深Ⅱ度烧伤创面的有效、安全的外用药。     

几种深Ⅱ度烧伤创面处理方法的回顾及改善创面微循环的初步实验研究

目的回顾性分析几种深Ⅱ度烧伤创面的修复方法,探讨改善创面微循环对创面愈合的意义. 方法 (1)对于笔者单位烧伤患者的深Ⅱ度创面,应用削痂疗法治疗614例、磨痂疗法治疗32例、清创后异体皮覆盖86例、外用磺胺嘧啶银后创面暴露1 836例、外用中药京万红烫伤膏包扎治疗408例.统计、分析各种疗法的治疗效果.(2)制作大鼠深Ⅱ度烫伤模型.伤后5 min内分别由其尾静脉注入等渗盐水(对照组,10只)、巴曲酶(治疗组,10只),创面均外用磺胺嘧啶银.测定两组大鼠伤前及伤后0.5-72.0 h的创面皮肤血流灌注单位,计算其伤后14、18 d的创面愈合率、收缩率及创面愈合时间.用组织学方法观察两组大鼠创面愈合后的皮肤毛囊数. 结果 (1)削痂疗法术后2-3周创面愈合,其中烧伤总面积50%～79%TBSA的患者治愈率94.8%,总面积80%～98%TBSA者治愈率93.4%.磨痂疗法磨痂+异体皮覆盖术后(13.8±2.1)d创面愈合,无瘢痕形成.清创后异体皮覆盖其中82例患者术后(18.0±2.3)d创面愈合.外用磺胺嘧啶银后暴露其中1 658例患者用药后(26.0±3.2)d痂下愈合.外用京万红烫伤膏后包扎患者多有细菌感染,其中下肢创面愈合时间为(26.0±2.8)d.(2)治疗组大鼠伤后2.0-72.0 h创面局部血流灌注单位均明显高于对照组(P<0.01).伤后14、18 d,治疗组创面愈合率明显高于对照组(P<0.01),但两组创面收缩率接近(P>0.05).治疗组创面愈合时间短于对照组(P<0.01).伤后30 d,对照组大鼠真皮层中残存少量毛囊,数量明显少于治疗组(P<0.01). 结论深Ⅱ度烧伤后早期采用削痂、磨痂或清创后覆盖异体皮的方法处理创面,可减轻感染、缩短疗程、提高治愈率和愈合质量.使用巴曲酶可改善深Ⅱ度烧伤创面微循环,加快愈合速度.     

Results of a multicenter outpatient burn study on the safety and efficacy of Dimac-SSD, a new delivery system for silver sulfadiazine

Dimac with silver sulfadiazine (Dimac-SSD), a new silver sulfadiazine delivery system, was evaluated prospectively in a multicenter study for the treatment of outpatient burn injuries. The goal of this study was to evaluate the effect of Dimac-SSD on the microbiology of the burn wounds and to quantitate its clinical safety and efficacy. A total of 197 patients were evaluated. Eight (4%) of these patients did not complete the study. Six patients withdrew because of local discomfort caused by the Dimac-SSD and two patients were terminated because of technical problems. The mean +/- SD duration of treatment with Dimac-SSD was 12 +/- 8.5 days, during which time the mean number of dressing changes was 2.9 per patient. During treatment with Dimac-SSD, the burn wound bacterial flora remained stable and overgrowth with Pseudomonas species or Gram-negative bacilli did not occur. Only four (2%) patients developed clinical infections; thus the Dimac-SSD appeared to have good antimicrobial effectiveness. This dressing was not associated with any organ system or metabolic side-effects and patient discomfort during application and removal was minimal. Thus this new delivery system for silver sulfadiazine was associated with excellent wound healing, a low incidence of wound infections, reduced frequency for dressing changes, and excellent patient compliance.     

纳米银敷料在修复Ⅱ度烧伤创面的应用研究

目的观察纳米银敷料在Ⅱ度烧伤创面的防治感染作用及对创面愈合时间的影响。方法将Ⅱ度(深、浅)烧伤创面患者随机分为纳米银敷料组(A组,65例),1%磺胺嘧啶银霜组(B组,63例)和凡士林油纱组(C组,63例)。创面敷料或用药每天更换1次,使用前后进行创面细菌培养,观察创面愈合时间并进行统计学比较。结果在防治创面细菌定植方面,治疗后创面细菌培养阳性率A组(0%)与B组(1·6%)相似,均较治疗前下降,而C组治疗后细菌培养阳性率(14·3%)较治疗前(4·8%)明显增加。A组浅Ⅱ度创面愈合时间为(9·6±1·6)d,与B、C两组比较均明显提前(P<0·01);A组深Ⅱ度创面愈合时间为(19·1±2·6)d,与C组比较差异具有统计学意义(P<0·01),与B组比较差异无统计学意义(P>0·05)。结论Ⅱ度烧伤创面应用纳米银敷料,可以降低患者创面感染的风险,缩短创面愈合时间。     

A randomized comparative trial between Acticoat and SD-Ag in the treatment of residual burn wounds, including safety analysis

OBJECTIVE: To investigate and evaluate the clinical efficacy and safety of Acticoat with nanocrystalline silver for external use on the management of the residual wounds post-burn. METHODS: One hundred and sixty-six wounds of 98 burn patients were enrolled and divided into Acticoat group and silver sulfadiazine group in the multi-center randomized clinical trial. Acticoat was used as the treated group for those who have redness, swelling, and excessive secretion ("heavy" exudates) in the wound, Acticoat was changed once a day. When there is not much secretion in the wound, or redness and swelling were not obvious, the dressings were changed once every 3 days. Silver sulfadiazine (SD-Ag) was used as control group, which was treated under the usual clinical routine. Healing time was observed up to 20 days. Healing percentage on the 15th day after treatment was determined. RESULTS: Healing time was 12.42+/-5.40 days after the application of Acticoat. This was significantly shorter than that of control wounds. The wounds of the trial group healed nearly 3.35 days earlier than the control ones. Healing percentage at 15 days in the trial wounds was 97.37%, which was higher than the control, but there was no significant difference between them. The bacterial clearance rate of the Acticoat group on the 6th and 12th day post-treatment was 16.67 and 26.67%, respectively, which was significantly higher than the control. CONCLUSIONS: Acticoat with nanocrystalline silver promotes the healing process of residual wounds post-burn effectively. No adverse reaction of Acticoat was found during the study.     

硝普钠和磺胺嘧啶银联合应用对大鼠深Ⅱ度烧伤创面愈合的影响

目的：研究硝普钠、磺胺嘧啶银及二者合用对深Ⅱ度烧伤皮肤创面愈合的影响。方法：100只WiStar大鼠背部深Ⅱ度烧伤创面,随机分成0．9％氯化钠注射液组、1％磺胺嘧啶银霜组、lmmol／L硝普钠组和1％磺胺嘧啶银霜＋lmmol／L硝普钠组。每组25只大鼠。动态观察烧伤后不同时间点创面细胞增殖周期、羟脯氨酸含量及创面组织愈合情况,计算创面愈合率。结果：伤后随时间推移磺胺嘧啶银霜＋硝普钠组创面愈合率高于其他三组;伤后第10天,磺胺嘧啶银霜＋硝普钠组创面羟脯氨酸含量、细胞S期百分比达到峰值,明显高于0．9％氯化钠注射液（P〈O．01）,磺胺嘧啶银霜组、硝普钠组之间比较无显著差异（P〉0．05）。结论：磺胺嘧啶银霜和硝普钠合用可有效促进大鼠深Ⅱ度烧伤创面愈合。     

The effect of 5% mafenide acetate solution on bacterial control in infected rat burns

Mafenide acetate is commonly available as a 10% cream and has been shown to be effective in the prevention and control of burn wound sepsis. The high osmolarity of the cream has been implicated in the pain upon application and the neoeschar formation often seen with its use. Mafenide acetate as a 5% solution has a lower osmolarity, and clinical trials with this agent have shown it to be both well accepted by patients and effective in wound preparation. Information concerning its antibacterial efficacy in comparison with other agents, however, has been lacking. Utilizing the Walker burn model, we have found the 5% mafenide acetate solution used as gauze soaks to be equal to mafenide acetate cream and better than silver sulfadiazine in attaining bacterial control of this experimental burn wound in the rat. The 5% solution provided prompt decrease in bacterial counts to less than 10(5) bacteria per gram of tissue in a majority of wounds by 48 hours of treatment. In addition, such wounds showed no evidence of neoeschar formation. In light of the efficient bacterial control and rapid preparation of the wound for grafting seen in this model, more extensive clinical use of the 5% mafenide acetate solution appears justified.     

A Comparative Study of the Burn Wound Healing Properties of Saline-Soaked Dressing and Silver Sulfadiazine in Rats

The purpose of this study was to further investigate that phenomenon and to explore the effect silver sulfadiazine on wound healing. Full-thickness burn wounds were created on the dorsum of Wistar albino rats under anesthesia. The wounds were treated with silver sulfadiazine and saline-soaked dressing for fourteen days, and then observed until healed. Wound surface area was measured each three days. Time to 50% and 90% healing was compared. No clinical infections occurred. Wound half-life and healing times were shortest in the saline-soaked group (P < 0.0001) in full-thickness burns. Wound contraction was delayed by silver sulfadiazine. These data suggest that silver sulfadiazine retard burn wound healing. Infection control without delay of burn wound healing is most appealing and clinical trials are planned.     

芦荟提取物对烫伤大鼠创面组织一氧化氮及内皮素含量的影响

目的观察芦荟凝胶和芦荟粗多糖对烫伤大鼠创面组织含水量及一氧化氮(NO)和内皮素(ET)含量的影响。方法将42只Wistar大鼠背部造成4个直径为3 cm的深Ⅱ度烫伤创面。伤后创面分别外敷质量分数5％芦荟粗多糖膏、质量分数10％芦荟凝胶膏、质量分数1％磺胺嘧啶银(SD-Ag)霜和等渗盐水。根据创面用药的不同分为芦荟粗多糖组、芦荟凝胶组、SD-Ag组、等渗盐水组。伤后4、12、24、48 h及7、14、21 d每时相点处死6只大鼠,取创面全层皮肤测定组织含水量、No和ET含量,计算No／ET值。另取6只大鼠不烫伤,作为正常对照组,检测指标同前。结果伤后12、24、48h,芦荟粗多糖组[(73.4±3．8)％、(76．6±3．0)％、(70．6±3．8)％]和芦荟凝胶组[(74.5±2.6)％、(77．1±3．6)％、(71．2±3．1)%]创面组织含水量显著低于SD-Ag组[(80．1±4．1)％、(80．5±3．9)％、(76．1±3．8)％,P<0．05];伤后7-21 d,除SD-Ag组伤后7 d仍显著高于正常对照组(P<0．05)外,其他各组均基本恢复到正常水平。伤后12 h各烫伤组创面组织NO含量升高达峰值,随后下降,到伤后21d仍显著高于正常对照组(P<0．05);伤后12、24 h,芦荟粗多糖组和芦荟凝胶组创面组织NO含量明显低于SD-Ag组及等渗盐水组(P<0．05)。伤后7 d或14 d各烫伤组创面组织ET含量增加达高峰,随后下降;伤后7、14d均显著高于正常对照组(P<0．05)。伤后12 h各组NO／ET值达峰值,随后下降,伤后14 d基本恢复至正常水平,其中芦荟粗多糖组伤后7 d NO／ET值即恢复至正常水乎,但其他3组仍显著高于正常对照组。结论芦荟粗多糖和芦荟凝胶能有效减少烫伤后早期创面组织NO的释放、优化NO／ET值、减轻血管炎性反应、减少渗出和水肿。     

Cerium nitrate: a new topical antiseptic for extensive burns.

The wounds of 60 burned patients were treated topically with cerium nitrate, which was applied either as a cream or in aqueous solution. Cerium nitrate has a potent antiseptic effect in human burn wounds, especially against gram negative bacteria and fungi. Pseudomonas aeruginosa was recovered from the wounds infrequently and never predominated. Fungi were practically never found. No patient treated with cerium developed a necrotizing wound infection. Analysis of the detailed bacteriological data indicated that, in contrast to previous results with use of the nitrate or sulfadiazine salts of silver, when gram negative species predominated, the flora tended to be predominantly gram positive when cerium was used. Therefore, some patients were treated simultaneously with cerium nitrate and silver sulfadiazine; this resulted in an even more efficient suppression of the wound flora than was observed previously with either cerium alone or silver salts alone; results with the simultaneous topical therapy in patients with injuries that previously were uniformly lethal were excellent. No toxicity attributable to the use of cerium was observed, although one instance of methemoglobinemia due to nitrate was documented. The adsorption of topically applied cerium essentially is nil. The use of cerium nitrate was associated with a nearly 50 percent reduction in the anticipated death rate. Cerium nitrate is a promising new topical antiseptic agent for the treatment of burns, particularly when it is used in combination with silver sulfadiazine.     

Treatment of dermal depth burn wounds with an antimicrobial agent-releasing silicone gel sheet

Silicone gel sheets containing 0.02 per cent Ofloxacin were used in the treatment of 24 patients with a total of 27 dermal depth burn wounds. The gel provided a continuing drug delivery system from the dressing to the wound. Clinically the silicone gel sheets did not adhere to the wound and could be removed easily without pain. No infection developed in any of the dermal depth burn wounds treated with the gel sheets. The silicone gel sheets were found to promote prompt epithelialization in 16 burn wounds of superficial dermal depth (mean 8.4 days) compared with ointment-impregnated gauze dressings (mean 14 days, P less than 0.01). There was less pain and discharge by macroscopic observation of the absorbent materials from both dressings. In nine wounds of mixed superficial and deep dermal burn, the silicone gel also provided prompt epithelialization (mean 12 days) compared to the control wounds (mean 22 days, P less than 0.01).     

创面用变革对深Ⅱ°烧伤创面愈合时间的影响

目的通过对深Ⅱ°烧伤创面愈合时间的分阶段对比分析,了解创面愈合观念及创面用药变革对创面愈合速度的影响。方法1982年1月～1999年12月对1563例小面积深Ⅱ°烧伤患者(总面积≤10%),按创面补锌及生长因子和胶原酶应用等治疗措施采用时间不同,分为时间阶段,对比观察创面愈合速度变化。结果1982年1月～1990年12月,未使用特殊创面外用药物,创面愈合时间为(23.8±3.5)天;1991年～1996年,采用银锌霜创面补锌,创面愈合时间为(20.6±3.2)天;1997年～1999年,将脱痂药物(胶原酶)及生长因子与银锌霜联合使用,使创面愈合时间缩短为(16.2±2.8)天。结论创面愈合观念及创面用药变革促进了深Ⅱ°创面愈合。     

Healing of partial thickness porcine skin wounds in a liquid environment.

This study employs a liquid-tight vinyl chamber for the topical fluid-phase treatment of experimental wounds in pigs. Continuous treatment with normal saline significantly reduced the early progression of tissue destruction in partial thickness burns. Uncovered burns formed a deep layer of necrosis (0.49 +/- 0.004 mm, mean +/- SD) although burn wounds covered with empty chambers demonstrated less necrosis (0.14 +/- 0.01 mm), fluid-treated wounds formed no eschar, and little tissue necrosis could be detected (less than 0.005 mm). Topical treatment with hypertonic dextran increased water flux across burn wounds by 0.24 ml/cm2/24 hr (mean, n = 95) over saline-treated wounds during the first 5 days after wounding. When partial thickness burn and excisional wounds were immersed in isotonic saline until healed, the daily efflux of water, protein, electrolytes, and glucose across the wound surface declined during healing to baseline values found in controls (saline-covered unwounded skin). The declining protein permeability was used as a reproducible, noninvasive, endogenous marker for the return of epithelial barrier function. Saline-treated excisional wounds healed within 8.6 +/- 0.6 days (mean +/- SD, n = 27) and burn wounds within 12.1 +/- 1.4 days (mean +/- SD, n = 15). Healing of fluid-treated wounds occurred without tissue maceration and showed less inflammation and less scar formation than healing of air exposed wounds (no attempt was made to compare rates of healing between air- and fluid-exposed wounds). We consider the fluid-filled chamber a potentially very useful diagnostic, monitoring, and delivery system for wound-healing research and for human wound therapy.     

An evaluation of the role of systemic antibiotic prophylaxis in the control of burn wound infection at the Lagos University Teaching Hospital

A prospective study was carried out on 61 patients to evaluate the role of systemic antibiotic prophylaxis in the control of burn wound infection. The patients were randomised into three groups: group 1 (n=21) received ampicillin and cloxacillin; group 2 (n=20) received erythromycin and genticin and a control group (n=20) received no systemic chemo prophylaxis. The burn wounds were similarly managed. Wound colonisation was determined from surface wound swab cultures and wound infection was determined from wound biopsy cultures and histopathology. The colonisation time (days) for the groups was 2.90+/-0.92, 3.15+/-0.77 and 3.05+/-0.83 for groups 1 and 2 and the control, respectively. The commonest organism isolated from contaminated wounds was Staphylococcus aureus. Wound infection was established in 5.70+/-1.70, 5.75+/-1.62 and 5.6+/-1.90 days for group 1, group 2 and the control group, respectively. There was no significant difference between wound infection time of control and group 1 nor was there such difference between the control and group 2 (P>0.05). The commonest organism infecting burn wounds in all the groups was Pseudomonas aeruginosa followed by S. aureus. There was however a significant difference between the treatment groups and the control (P<0.05) with regard to the percentage of infected wounds that grew P. aeruginosa, compared to those that grew S. aureus. It was concluded that systemic antibiotic prophylaxis is of no value in controlling burn wound sepsis, and might even favour the growth of P. aeruginosa in the burn wounds.     

重组人表皮细胞生长因子治疗烧伤创面研究

目的　探讨外用重组人表皮细胞生长因子 (rh EGF)治疗 度烧伤创面最佳用药方式。　方法　 2 0 0 0年6月～ 2 0 0 1年 12月对 6 0例浅 度和深 度烧伤患者共 180个创面进行随机双盲实验 ,每例患者设 A、B、C 3个治疗区。A区为 SD- Ag对照治疗区 ,1% SD- Ag霜涂创面 ,每日 1次 ;B区为 rh EGF治疗区 ,rh EGF4 0 U/ cm2 直接喷在创面上 ,每日 1次 ;C区为 rh EGF和速愈平混合治疗区 ,rh EGF4 0 U/ cm2和速愈平 5 g混合涂在创面上 ,每日 1次 ;每日观察记录 3个治疗区变化 ,直至创面愈合停止用药 ;愈合 1周后检查创面外观、皮肤弹性 ,并行统计学处理。　结果　浅 度创面 A区愈合时间为 (13.2 0± 2 .4 0 )天 ,B区为 (10 .2 0± 2 .2 0 )天 ,C区为 (8.72± 2 .31)天 ,组间比较有统计学意义 (P<0 .0 1) ;深 度创面 A区愈合时间为 (2 0 .10± 3.4 0 )天 ,B区为 (17.2 0± 3.12 )天 ,C区为 (15 .10± 3.81)天 ,组间比较有统计学意义 (P<0 .0 1和 P<0 .0 5 )。治疗期中 A区渗出液、创缘炎性反应均较 B、C区显著。深 度创面愈合后 B、C区无充血 ,有弹性和韧性 ;A区充血 ,无弹性和韧性。　结论　rh EGF对烧伤创面有明显促愈合作用 ,可改善愈合质量。rh EGF和速愈平联合使用对缩短创面愈合时间及提高愈合质量作用     

Evaluation of wound healing activities of kefir products

Kefirs are natural probiotic compounds with antibacterial and anti-inflammatory properties which were tested in experimental burn injury. Kefir gels were prepared from an extract of continuously cultured kefir grains in MRS Broth medium for 24, 48 and 96h. Similar burn injuries were made on dorsal skin surface of 56 rats. After 24h the wounds were infected with Pseudomonas aeruginosa. The infected rats were divided in to 7 groups of 8 rats each. The base gel, silver sulfadiazine ointment, kefir 24h gel, kefir 48h gel, kefir 96h gel and kefir grains 96h gel were applied twice a day. Burn wound area was measured at baseline, one and two weeks. After two weeks the animals in all groups were sacrificed and whole skin wound areas were removed and percentage of epithelization, scar formation, inflammation and angiogenesis were evaluated. Results indicated that at the end of the 2nd week the percentage of wound size were lowest in order of kefir 96h gel相似文献