微环境pH值对慢性创面愈合影响的研究进展

微环境pH值在慢性创面愈合中起重要作用，作者就创面微环境pH值对慢性伤口愈合过程的影响、评估创面微环境pH值的措施及调适创面微环境pH值的护理方法进行综述，为提升慢性伤口患者的创面愈合效果提供借鉴。     

PRP联合新型敷料在治疗慢性伤口中的应用效果观察

目的研究富血小板血浆(PRP)联合新型敷料在治疗慢性伤口中的应用效果。方法选取我院慢性伤口患者67例,按入院顺序分为2组。对照组(33例)采取传统敷料干预,观察组(34例)采取PRP联合新型敷料干预。比较2组的疗效。结果观察组伤口愈合时间短于对照组;干预1周、2周、4周、6周后VAS评分低于对照组;护理效果满意度高于对照组。以上差异均有统计学意义(P0.05)。结论 PRP联合新型敷料应用于治疗慢性伤口,可减轻疼痛程度,缩短伤口愈合时间,提高护理效果满意度。     

软聚喹酮泡沫敷料在妇科肿瘤患者术后愈合不良伤口中的应用

目的:观察妇科肿瘤患者术后愈合不良伤口应用软聚喹酮泡沫敷料(商品名叫美皮康)治疗的效果、患者的舒适感及费用的比较.方法:选择2008年1月至2010年12月妇科肿瘤患者术后伤口愈合不良患者共120例,随机分为观察组与对照组,观察组应用软聚喹酮泡沫敷料进行换药,对照组应用传统敷料进行换药,观察伤口愈合情况,对患者的舒适及疼痛进行问卷调查,并且比较两组费用情况.结果:观察组伤口愈合时间较对照组明显缩短(P＜0.01);换药次数明显少于对照组(P＜0.001),而费用并未增加;换药时舒适度优于对照组(P＜0.01),疼痛明显减轻.结论:妇科肿瘤患者术后愈合不良伤口应用软聚喹酮泡沫敷料进行换药,治疗效果明显优于传统换药法;换药时舒适度优于对照组,疼痛明显减轻,而费用并未增加.此方法值得临床推广.     

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...     

人工智能用于慢性伤口护理的研究进展

阐述了人工智能的概念,人工智能在伤口评估、敷料制备、伤口愈合预测等方面的应用,提出人工智能技术应用于伤口护理可提高护理效率和质量,应制定统一的伤口图像采集标准、优化人工智能设计、鼓励护理人员积极学习人工智能相关知识,使人工智能更好地服务于伤口护理。     

应用预防性减张缝合对腹部切口愈合质量的影响观察

腹部外科手术中腹壁切口的愈合质量一直是病人及外科医师关注的重要问题之一。国外报道切口愈合不良导致切口疝的发生率达11％-20％，切口裂开的发病率为1％-3％。其死亡率高达15％～20％。1998年7月-2003年6月我科对高危因素的病人应用预防性减张缝合技术(prophylactic tention suture，PTS)共562例，无一例发生切口裂开，与1993年7月-1998年6月的病例比较，明显减少了其他切口并发症。现报告如下。     

急性创面无干扰伤口愈合的护理研究进展

介绍无干扰伤口愈合的概念及其在急性创面处理中的应用现状,分析无干扰伤口愈合在急性创面愈合中的促进因素及效果评价,以期为医护人员在临床实践中重视将急性创面处于无干扰愈合环境,结合患者情况,制定最佳的创面处理方案提供参考。     

水胶体敷料对腹膜透析患者手术切口的愈合护理效果

目的 探讨水胶体敷料的换药方法替代传统敷料的换药方法对腹膜透析患者手术切口的愈合护理效果.方法 回顾性分析了88例腹膜透析患者手术切口的护理效果,其中使用水胶体敷料换药的患者为实验组,共44例,使用传统敷料换药的患者为对照组,共44例.比较两组手术切口的愈合天数.结果 实验组的伤口愈合时间为（9.0±6.3）d,对照组愈合时间为（14.0±9.8）d,两组比较有显著性差异（P＜0.05）.结论 水胶体敷料能促进腹膜透析患者手术切口的愈合,减轻患者的痛苦,提高舒适度.     

富血小板血浆对下肢慢性难愈合伤口的修复作用及外观影响

目的：研究富血小板血浆(Platelet-rich plasma,PRP)对下肢慢性难愈合伤口的修复作用及外观影响。方法：选择笔者医院2017年3月-2019年8月诊治的91例下肢慢性难愈合伤口患者,随机数字表法分为PRP组(46例)和对照组(45例),其中前者给予PRP+负压封闭引流(Vacuum sealing drainage,VSD)治疗,后者仅给予VSD治疗。比较两组患者伤口愈合情况以及愈合时间、疼痛程度和温哥华瘢痕量表(Vancouver scar scale,VSS)评分,并检测治疗前后血清炎症因子水平。结果：治疗后PRP组伤口pH值、PUSH评分以及愈合时间均显著低于对照组,伤口温度高于对照组,差异有统计学意义(P<0.05)。两组治疗次数比较差异无统计学意义(P>0.05)。治疗后1周、2周PRP组疼痛评分均显著低于对照组,差异有统计学意义(P<0.05)。治疗后2个月、4个月PRP组VSS评分均显著低于对照组,差异有统计学意义(P<0.05)。治疗后PRP组C反应蛋白(C-reaction protein,CRP)、降钙素原(Procalci...     

湿性敷料在腹部手术术后伤口愈合不良中应用效果的观察

伤口愈合不良是外科手术后常见的并发症之一,发生率约为8．4％,不仅增加患者痛苦及治疗费用,延长患者住院时间,还会危及患者的生命,增加医护人员的工作量。我们选择应用以康惠尔系列产品为代表的湿性敷料用于腹部手术术后愈合不良伤口的换药,并与传统纱布敷料换药效果相比较,报告如下。     

慢性伤口感染常见病原菌及其干预效果研究

目的探讨慢性伤口常见病原菌种类、阳性率及其分布对伤口愈合的影响,分析含银敷料对不同种类病原菌的干预效果及其有效作用时间,为临床有效护理伤口提供依据。方法对入选的178例慢性伤口按照统一方法评估、清洗伤口和清创,含银敷料覆盖或填充,隔日处理1次,连续干预28d,随访3个月。结果干预前检出致病菌阳性率和耐药菌阳性率分别为76.40%和67.42%,病原菌10种,排序前3的依次为金黄色葡萄球菌(31.46%)、铜绿假单胞菌(13.48%)和大肠杆菌(8.43%)。含银敷料干预后7d病原菌阳性率有不同程度下降,干预14d和28d阳性率进一步下降,以大肠杆菌和金黄色葡萄球菌下降最明显。干预后14d伤口面积缩小,干预后7d疼痛计分下降,干预28d面积缩小和疼痛减轻最明显。干预期内和随访期内愈合率分别为18.54%(33例)和87.08%(155例)。结论慢性伤口中存在高阳性率的病原菌,影响伤口愈合。含银敷料对不同细菌抑菌效果存在差异性,至少连续使用2~4周才能奏效。临床需结合伤口类型、细菌种类等综合分析,动态调整,合理使用含银敷料。     

乳猪皮生物敷料对创面愈合的影响

目的:探讨乳猪皮生物敷料促进创面愈合的机理。方法:用凡士林纱布做对照,将乳猪皮生物敷料覆盖猪皮肤缺损创面,观察创面面积、愈合时间、炎性反应及肉芽生长等组织学改变。结果:乳猪皮生物敷料较对照组凡士林纱布能加速创面愈合(P<0.01),减少炎性细胞浸润和肉芽生长。结论:乳猪皮生物敷料促进创面愈合并提高愈合的质量,并可在常温下较长时间保存,是创面修复的一种较理想的生物敷料。     

A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients

To compare the effect of honey dressing and silver-sulfadiazene (SSD) dressing on wound healing in burn patients. Patients (n=78) of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area) were included in the study, over a period of 2 years (2006-08). After stabilization, patients were randomly attributed into two groups: ‘honey group’ and ‘SSD group’. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37) and SSD cream over the wounds of patients in SSD group (n=41), everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group) and control (SSD group) was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100%) who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound healing, makes the wound sterile in lesser time, has a better outcome in terms of prevention of hypertrophic scarring and post-burn contractures, and decreases the need of debridement irrespective of time of admission, when compared to SSD dressing.     

Treatment of chronic ulcer with elastic plasma protein and platelet film for wound dressing

Abstract

Experimental results have previously been reported for a new biological dressing consisting of concentrated plasma proteins and platelet-rich plasma (PRP), which is named Platelet-Protein film (PPF). This study reports clinical experience using PPF produced from the patients' own blood by the original technique. Ten patients with chronic wounds underwent PPF treatment and evaluated the transcutaneous oxygen tension (TcPO₂) and vascular density. Eight of the 10 patients received a split-thickness skin graft on induced granulation tissue and have remained free from complications for more than 12 months since treatment. The TcPO₂ values significantly increased at 4 days after treatment (before 38.4 (14.1) mmHg, after 55 (19.9) mmHg, p < 0.01). The vascular density at the ulcer base increased at 14 days after treatment in all the cases. The results showed that PPF has the potential to enhance chronic wound healing.     

The impact of topical agents and dressing on pH and temperature on wound healing: A systematic,narrative review

To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, Web of Science, and Scopus. Data synthesis and analysis were conducted using a structured narrative synthesis. The quality of the included clinical studies was appraised using the Evidence‐Based Literature (EBL) Critical Appraisal Tool. A total of six clinical studies were assessed as eligible for inclusion, A total of six dressings/topical agents were assessed and the types of wounds included non‐healing chronic wounds. Of the studies, five explored pH and one explored temperature. The EBL validity of the clinical studies was low (mean quality score was 51.3%). The five clinical studies that explored pH investigated different dressings and topical agents reporting an associated reduction in pH and improved wound outcomes. One clinical study investigated the impact of topical sodium nitrite on temperature and found that sodium nitrite increased peri‐wound skin temperature and improved wound outcomes with a reduction in leg ulcer size. Given the low certainty of the evidence, we cannot confidently recommend the use of any particular topical agent or dressing to manipulate pH, or temperature to improve wound outcomes. Thus, there is a need for further research to develop a greater understanding of this topic. Irish Research Council, Enterprise Partnership Scheme.     

Preservation of the properties of elastic plasma protein plus platelet film for wound dressing

Abstract

Experimental results have previously been reported for a new biological dressing consisting of concentrated plasma proteins and platelet-rich plasma (PRP), which is named Platelet-Protein film (PPF). Based on the results of this experimental study, a clinical trial was begun to examine the usefulness of PPF. Although fresh autologous PPF is being used in the clinical trial, it is considered that the use of a preserved material prepared in advance would enable more convenient application. To verify the usefulness of preserved PPF, this preliminary study was conducted to examine the effects of fresh PPF, preserved PPF or blood clot, as control, applied to excisional skin defects in healing-impaired mice. The wound area and vascular density were analysed on day 9 after wound creation. Significant decrease of the wound size was observed in the preserved PPF and fresh PPF groups (4.2 (3.7), 2.2 (0.53)%) in comparison with that in the control group (38.5 (18.6)%, p < 0.05). Furthermore, a significant increase of the vascular density was also observed in the preserved PPF and fresh PPF groups (0.055 (0.021), 0.050 (0.019) mm²/mm²) as compared with that in the control group (0.016 (0.010) mm², p < 0.01). There was no significant difference in the effect on the wound size or vascular density between the preserved PPF and fresh PPF groups. The results showed that the properties of PPFs could be maintained for at least 1 week under appropriate storage conditions. The possibility of preservation of PPF for future use could be of practical advantage in actual clinical situations.     

Comparison of wound healing and patient comfort in partial‐thickness burn wounds treated with SUPRATHEL and epictehydro wound dressings

Among the available dressings for partial‐thickness burn wound treatment, SUPRATHEL has shown good usability and effectiveness for wound healing and patient comfort and has been used in many burn centres in the last decade. Recently, bacterial nanocellulose (BNC) has become popular for the treatment of wounds, and many studies have demonstrated its efficacy. epicite^hydro, consisting of BNC and 95% water, is a promising product and has recently been introduced in numerous burn centres. To date, no studies including direct comparisons to existing products like SUPRATHEL have been conducted. Therefore, we aimed to compare epicite^hydro to SUPRATHEL in the treatment of partial‐thickness burns. Twenty patients with partial‐thickness burns affecting more than 0.5% of their total body surface area (TBSA) were enrolled in this prospective, unicentric, open, comparative, intra‐individual clinical study. After debridement, the wounds were divided into two areas: one was treated with SUPRATHEL and the other with epicite^hydro. Wound healing, infection, bleeding, exudation, dressing changes, and pain were documented. The quality of the scar tissue was assessed subjectively using the Patient and Observer Scar Scale. Wound healing in patients with a mean TBSA of 9.2% took 15 to 16 days for both treatments without dressing changes. All wounds showed minimal exudation, and patients reported decreased pain with the only significant difference between the two dressings on day 1. No infection or bleeding occurred in any of the wounds. Regarding scar evaluation, SUPRATHEL and epicite^hydro did not differ significantly. Both wound dressings were easy to use, were highly flexible, created a safe healing environment, had similar effects on pain reduction, and showed good cosmetic and functional results without necessary dressing changes. Therefore, epicite^hydro can be used as an alternative to SUPRATHEL for the treatment of partial‐thickness burn wounds.     

功能性敷料促进供皮区创面愈合的临床研究

目的:观察功能性敷料对供皮区创面愈合的作用。方法:对48例患者行大腿外取皮,将供皮区创面分为治疗组即用功能性敷料覆盖及对照组即用凡士林纱布覆盖,分别观察治疗组和对照组供皮区创面的愈合时间。结果:创面愈合的平均时间,治疗组为(9.2±1.2)天,对照组为(13.3±2.6)天,两者比较P<0.01差异有显著意义。结论:功能性敷料能促进供皮区创面的愈合。