苯妥英锌对烧伤的临床治疗作用

目的 :观察苯妥英锌治疗烧伤的作用。方法 :选择烧伤部位的面积和深度相近的 19例Ⅱ度烧伤患者 ,分为两组 ,分别用苯妥英锌和磺胺嘧啶银的软膏 (2 5 % )外用治疗 ,观察创面肿胀程度、发炎、创面结痂、局部疼痛以及创面愈合时间 ,并进行烧伤后创面组织学检查。结果 :苯妥英锌组创面的渗出比对照组少 ,疼痛明显减轻 (P <0 .0 5 ) ,创面细菌的转阴率 1wk后为 30 % (对照组为 33.3% ) ,创面愈合时间为 16.1± 2 .8d(对照组为 16.8± 2 .7d) ,创面毛细血管胚芽与成纤维细胞数量明显多于对照组。结论 :苯妥英锌对Ⅱ度烧伤的治疗优于磺胺嘧啶银     

苯妥英用于创伤愈合的研究进展

根据国内外献报道，对苯妥英在创伤愈合方面的应用及作用机理作进一步的归纳和总结。苯妥英对各种创伤有明显的促进愈合的作用，在创伤方面有很好的应用前景。     

四妙君逸软膏换药用于促进肛肠病术后创面愈合的研究

目的:探讨四妙君逸软膏促进创面愈合的作用及机制。方法:将60只大鼠随机分成空白基质组、重组人表皮生长因子组、龙珠软膏组及四妙君逸软膏高、中、低剂量组,每组10只,制备大鼠创伤模型。治疗从造模后d 1开始至创面完全愈合,观察术后各组大鼠创面的愈合情况,于术后d 3,d 7和d 14记录创面愈合率,在d 7和d 14取材。采用考马斯亮兰法检测大鼠肉芽组织中蛋白含量、免疫组化ABC法检测表皮生长因子受体(EGFR),最后观察创面愈合时间。结果:四妙君逸软膏能缩短创面愈合时间,提高创面愈合率及创面肉芽组织中蛋白含量和EGFR。结论:四妙君逸软膏能促进创面愈合,其机制之一是通过提高EGFR以及蛋白含量来促进创面愈合。     

封闭负压引流技术与创面修复

封闭负压引流技术(vacuum-assisted closure,VAC)是1993年由德国Ulm大学Fleischmann最早提出的,以采用特殊材料覆盖伤口形成创面负压,达到加速清创和促进愈合的目的,主要应用于体表急、慢性、感染或非感染性伤口或溃疡,软组织大面积损伤,尤其是对慢性难愈性创面愈合方面有着不可替代的优势。VAC临床应用越来越广泛,有必要回顾近年相关文献,对VAC的发展、促进创面愈合的机制、临床应用等问题作一综述。     

苯妥英促进颌骨骨折早期愈合的实验研究

目的:探讨苯妥英对动物(家兔)颌骨(下颌骨)骨折愈合的影响。方法:建立颌骨骨折动物模型,经局部或腹腔应用苯妥英与对照组进行比较。分别于术后第8,16,30天,通过X线平片、光镜、扫描电镜观察以及血微量元素、碱性磷酸酶测定。结果:苯妥英局部及腹腔应用能促进胶原合成且排列有序,促进钙盐沉积,骨痂形成。术后第16,30天,血液中微量元素锌、铁、钙、镁及碱性磷酸酶,各组之间差异具有显著性(P<0.05)。结论:苯妥英能促进颌骨骨折早期愈合。     

胶原海绵促进肉芽生长与创面愈合实验研究

目的评价含胶原纤维不同的胶原海绵促进创面肉芽生长与愈合的疗效比较。方法将含胶原纤维较多的可即邦胶原海绵与较少的艾微停微纤维止血胶原海绵分别作为治疗组1与治疗组2,与对照组凡士林纱布比较,外用于兔背部机械性创面,于用药后3、7、14d分别测定创面面积愈合率、肉芽毛细血管密度、肉芽内血红蛋白含量及羟脯氨酸含量,并记录各组疮面愈合时间。结果创面愈合率及愈合时间,治疗组明显优于对照组,差异有统计学意义（P〈0.01）,其中第7天时创面愈合率及创面愈合时间,治疗组1优于治疗组2;创面肉芽毛细血管密度与血红蛋白含量,治疗组优于对照组（P〈0.01）,第7天时,治疗组1优于治疗组2,与创面愈合率一致;创面肉芽羟脯氨酸含量结果与创面愈合率一致,不同的是第14天时,治疗组1优于治疗组2。结论胶原海绵对创面具有促进愈合的疗效,作用机制之一是促进血管新生与胶原合成。含胶原纤维较高的可即邦胶原海绵更有利于创面愈合。     

左卡尼汀对手术切口愈合作用机制的进展与展望

手术切口愈合为外科工作者一直以来面临的重要问题,切口愈合不良的影响因素主要有营养不足、切口感染、血糖升高和灌流不足等,主要原因为体外感染源及自身免疫力下降。左卡尼汀通过不同作用机制促进手术切口创面愈合。综述左卡尼汀促进手术切口愈合的作用机制文献,并对其临床使用进展与展望作了分析。     

表皮生长因子对创面修复作用的临床观察

目的：观察表皮生长因子（rhEGF)对创面的修复作用。方法：选择30例各类创面,同时选择同体相似深度,相应部位30个创面作对照,创面清创后将浸透rhEGF的双层纱布敷于创面上,外敷凡士林油纱,无菌纱布包扎。每日或隔日换药,观察至愈合。结果：总显效率70%,可使浅Ⅱ度、深Ⅱ度创面分别提前3d、3.2d愈合,3例慢性创面平均18d愈合。结论：rhEGF对浅Ⅱ度创面有非常明显的促进创面愈合作用,对深Ⅱ度创面、慢性创面也有促进愈合作用。     

六味芦荟膏对感染性烧、烫伤创面的促愈合作用研究

目的:研究六味芦荟膏对感染性烧、烫伤创面的促愈合作用。方法:将Ⅲ度烧伤创面感染金黄色葡萄球菌模型大鼠与浅Ⅱ度烫伤创面感染绿脓杆菌模型小鼠分别随机分为赋形剂组、京万红阳性对照组与六味芦荟膏低、中、高剂量组,每组10只,记录创面面积、愈合时间,计算创面愈合率,以组织病理学评分考察创面愈合情况。结果:不同剂量的六味芦荟膏均能显著促进创面愈合(P<0.05)。结论:六味芦荟膏对感染性创面有促进愈合作用。     

抗氧化肽AOP_1对小鼠皮肤烫伤创面愈合修复的影响

目的探究抗氧化肽AOP_1促进小鼠皮肤烫伤创面愈合修复的作用及机制。方法选用DCFH-DA检测细胞内活性氧(ROS)的变化;通过细胞增殖与迁移实验检测药物毒性及对创面愈合的影响。采用直径1 cm铜柱80℃水浴2min、紧贴小鼠皮肤10 s的方法制备烫伤模型,观察烫伤创面愈合情况;并用HE和Masson三色染色观察AOP_1对皮肤烫伤创面愈合修复的作用;检测小鼠全皮组织中MDA含量和SOD活性。结果在细胞水平上,抗氧化肽AOP_1能够明显降低HaCaT和L929细胞内ROS的含量,促进细胞迁移和增殖。与对照组相比,AOP_1组小鼠皮肤创面愈合时间短、愈合率高,结痂面积小,可明显降低烫伤创伤组织中炎症反应及MDA的含量;HE和Masson染色也证实了AOP_1对烫伤创面愈合修复的促进作用。结论具有天然活性的抗氧化肽AOP_1可能通过减轻烫伤引起的氧化应激,促进小鼠皮肤烫伤创面的愈合修复。     

Role of phenytoin in wound healing--a wound pharmacology perspective

Topical agents used for the enhancement of wound healing are designed to act locally and, therefore, do not undergo classic systemic metabolic modification. This commentary reviews the potential role of a vulnerary agent, phenytoin, (PHT), from a wound pharmacology perspective. This agent may have the potential to alter the dynamics of wound healing, suggesting a therapeutic use for the stimulation of chronic wounds. Oral PHT therapy is used widely for the treatment of convulsive disorders, and about half the patients treated develop gingival overgrowth as a side-effect. This apparent stimulatory effect has prompted its assessment in wound healing. Investigations into the mechanisms of gingival overgrowth also provide clues to its action in wound healing, and important similarities and differences are discussed. It appears also that both gingiva and skin are important extrahepatic sites for xenobiotic metabolism, and analysis of the biochemical mechanisms should lead to the design of safer analogues for wound healing. On the other hand, differences between the pharmacokinetics of topical PHT in these tissue situations indicate that different formulations are required for gingival and cutaneous wound healing and during the changing course of wound healing itself.     

In Vitro Evaluation of Novel Phenytoin-Loaded Alkyd Nanoemulsions Designed for Application in Topical Wound Healing

Phenytoin-loaded alkyd nanoemulsions were prepared spontaneously using the phase inversion method from a mixture of novel biosourced alkyds and Tween 80 surfactant. Exposure of human adult keratinocytes (HaCaT cells) for 48 h to alkyd nanoemulsions producing phenytoin concentrations of 3.125-200 μg/mL resulted in relative cell viability readings using tetrazolium dye 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide of 100% confirming nontoxicity and suggesting cell proliferation activity. Phenytoin-loaded alkyd nanoemulsions generally resulted in higher mean cell viability compared with equivalent concentration of phenytoin solutions, suggesting that the nanoemulsions provided a controlled-release property that maintained the optimum phenytoin level for keratinocyte growth. HaCaT cell proliferation, measured by 5-bromo-2-deoxyuridine uptake, was found to increase following exposure to increasing phenytoin concentration from 25 to 50 μg/mL in solution or encapsulated in nanoemulsions but declined at a drug concentration of 100 μg/mL. An in vitro cell monolayer wound scratch assay revealed that phenytoin solution or nanoemulsions producing 50 μg/mL phenytoin concentration resulted in 75%-82% “scratch closure” after 36 h, similar to medium containing 10% fetal bovine serum as a cell growth promoter. These findings indicate that phenytoin-loaded alkyd nanoemulsions show potential for promoting topical wound healing through enhanced proliferation of epidermal cells.     

Application of chitosan-based nanoparticles in skin wound healing

The rising prevalence of impaired wound healing and the consequential healthcare burdens have gained increased attention over recent years. This has prompted research into the development of novel wound dressings with augmented wound healing functions. Nanoparticle(NP)-based delivery systems have become attractive candidates in constructing such wound dressings due to their various favourable attributes. The non-toxicity, biocompatibility and bioactivity of chitosan(CS)-based NPs make them ideal...     

美宝湿润烧伤膏在创面修复中的应用研究进展

近年来,对创面的管理及治疗成为临床研究热点,除了对创面换药及必要时手术治疗,促进创面愈合的药物也越来越被重视。美宝湿润烧伤膏（MEBO）近年被越来越多的文献报道应用在治疗烧伤及慢性创面中具有较好的抗感染及促进创面愈合效果;因此,本文就MEBO对创面修复愈合及抗炎效果的影响作综述,旨在对临床上指导优化用药以促进创面愈合。...     

Effect of phenytoin sodium on macrophages in rat wounds

本实验旨在研究苯妥英钠（ＰＳ）对伤口巨噬细胞（Ｍ）的影响．从置入大鼠背部伤口的聚乙烯醇海绵中收集巨噬细胞，分别测定其吞噬功能，肿瘤坏死因子α（ＴＮＦα）和白介素１（ＩＬ－１）的释放以及对成纤维细胞增殖调节作用，通过牵拉伤口组织致其断裂时溢出的水的重量而测定伤口牵张强度．结果表明，伤口Ｍ的功能在伤后ｄ５达到高峰，ＰＳ１，１０，５０ｇ·Ｌ－１浓度依赖性地增加伤后ｄ５的伤口Ｍ的数量，吞噬功能，ＴＮＦα和ＩＬ－１的释放，增强Ｍ对成纤维细胞增殖的刺激作用，增强伤口牵张强度．结果说明ＰＳ加速伤口愈合，与其增强Ｍ的功能有关．     

Efficacy of topical phenytoin on chemotherapy-induced oral mucositis; a pilot study

Background and the Purpose of the Study

Oral mucositis is one of the most common complications of malignancy chemotherapy. As yet, no absolute treatment has been demonstrated to be effective for chemotherapy-induced oral mucositis. This study evaluates the effectiveness of phenytoin mouthwash as a wound healing agent, on the basis of stimulating effects on fibroblast proliferation.

Materials and Methods

In this multicenter, randomized, placebo-controlled clinical trial; twelve patients received phenytoin mouthwash (0.5%) or placebo for about two weeks. Oral pain severity was scored on the daily basis using a VAS (visual analogue scale) of 10 centimeters. National Cancer Institute (NCI) scale was used to grade the intensity of mucositis. To determine the effect of treatment, a quality of life questionnaire, consisting of 35 queries, was filled out for all patients. Statistical analyses of data was performed using Mann-Whitney test.

Results

The average time for complete remission of mucositis in phenytoin-treated group was less than that of the placebo group. The quality of life improved dramatically in the phenytoin group with the healing process being more evident in the first week. Furthermore, reduction in the wound area was greater in the phenytoin group than controls at the end of the first week of treatment. Both groups eventually demonstrated reduction in pain intensity; however no statistically significant difference was observed between two groups.

Conclusion

Phenytoin mouthwash accelerated wound healing and resolution of mucositis and improved life quality impressively.     

基于数据挖掘的中医药促进创面修复用药规律的研究

目的 通过整理、挖掘古代典籍和现代文献中促进创面修复的用药规律,为促进修复的临床用药提供新思路。方法 收集文献中记载的促进创面修复方剂,建立数据库,采用数据挖掘技术进行分析。结果 在关于中医药促进创面修复的古籍文献中,纳入75首方剂和203味中药,促进创面修复的核心药物有乳香、甘草、当归、白芷、黄柏、没药等,用药种类以清热药、活血化瘀药、补虚药、解表药、拔毒化腐生肌药为主。对16味核心药物进行聚类分析和关联规则分析,得出4个聚类组合和15组药对及药组关联规则。结论 创面修复方剂的用药规律以清热、活血化瘀、补虚、解表、拔毒化腐生肌为主,中医治疗创面应针对热病、血瘀、虚证、腐烂溃破、表证、中毒等因素进行辨证论治。     

Recent patents on topical application of honey in wound and burn management

Topical application of honey to burn and wounds has been found to be effective in controlling infection and producing a clean granulating bed. It is suggested that the wound healing effect of honey may in part be related to the release of inflammatory cytokines from surrounding tissue cells, mainly monocytes and macrophages. It has been reported that honey hastens wound healing by accelerating wound contractions. Microscopic evaluation demonstrated that there was a significant acceleration of dermal repair in wound treated with honey. Macroscopic and microscopic observations under in vivo assessment suggested that the topical application of honey might have favourable influences on the various phases of burn and wound healing hence accelerating the healing process. The regulatory effects of honey are related to components other than the sugars. However, the mechanisms by which honey affects the release of anti inflammatory agents and growth factors from monocytic cells are as yet unclear. Whether honey affects other cell types, particularly endothelial cells and fibroblasts, involved in wound healing also needs to be clarified. The present article is a short review of recent patents on the healing effect of honey in wound and burn management.     

伤口治疗用载药微针的研究进展

在伤口治疗过程中,因皮肤屏障的限制,药物在角质层积聚使得治疗效率低。微针是治疗伤口的一种新型药物递送系统,可刺穿皮肤的表皮层,将药物送入真皮层,从而发挥促进伤口愈合的作用。该文综述了近几年国内外用于伤口治疗的微针系统,根据微针负载的药物对研究进行分类,并讨论了微针系统在促进伤口愈合方面的优势,总结了微针用于治疗伤口的未来前景和挑战。     

Ethosuximide and phenobarbital promote wound healing via enhancing collagenization

The fact that ethosuximide (ETO), phenobarbital (PHO), and barbituric acid (BARB) share structural and pharmacophoric homologies with phenytoin and allantoin, both known to have significant wound‐healing properties, prompted us to evaluate them as wound‐healing agents. Accordingly, ETO‐, PHO‐, and BARB‐containing ointments were applied onto full‐thickness excision and incision wounds created on the dorso‐lumbar region of experimental rats. ETO‐and PHO‐treated incision wounds illustrated significant enhancement in breaking strengths (1380 ± 61 and 1240 ± 42 g, respectively) compared to vehicle controls (1070 ± 18 g) and BARB (1080 ± 45 g). Moreover, biochemical analyses revealed significant increase in hydroxyproline contents in ETO‐ and PHO‐treated wounds compared to vehicle controls. Histological evaluation revealed that both ETO and PHO promoted collagen synthesis and deposition. This is the first time to describe the significant wound‐healing merits of ETO and PHO as potential clinical agents for treatment of chronic wounds.