新型敷料在供皮区创面的应用

在烧伤整形外科中,游离皮片移植术后存在供皮区本身的修复问题,如取皮留下的创面过大,该创面愈合时间较长,容易继发感染,形成瘢痕挛缩,最终影响美观甚至带来功能障碍等风险。目前,临床治疗中为促进供皮区创面良好愈合,减少瘢痕的增生,常常通过对供皮区创面应用敷料达到这一目的。随着对创面愈合机制的研究深入,人们认识到使用敷料不仅能覆盖创面,而且能促进创面愈合。在这种观点的指导下,人们尝试在创面运用不同的敷料。     

碳纤维敷料在烧伤创面中的临床应用

目的观察碳纤维敷料对烧伤创面的治疗作用。方法选择浅Ⅱ°、深Ⅱ°和残余创面共277例,随机分为对照组(碘伏纱布换药)和治疗组(碳纤维敷料换药)。观察敷料吸收容量、创面炎症反应,并做创面细菌定量和创面组织学检查,记录创面愈合时间等。结果与对照组相比,治疗组敷料吸收容量大,创面炎症反应轻,创周炎症消退快,痂下组织细菌定量低。浅Ⅱ°、深Ⅱ°及残余创面愈合时间分别为(7．4±2．1)d、(16．2±2．6)d、(19．4±6．2)d,均较对照组缩短,对照组分别为(9．6±2．4)d、(19．6±3．4)d和(28．8±10．4)d。结论碳纤维敷料是一种具有吸附能力强、可有效控制炎症反应、促进创面愈合等特点的新型敷料。     

创面生物活性玻璃新型敷料临床应用

通过系统阐述创面生物活性新型辅料的国内外研究文献,从原理与特色、临床应用效果以及发展前景等方面,进行系统阐述.     

复合碳纤维敷料的临床应用

烧伤创面包扎疗法通常使用脱脂纱布 ,其包扎厚度为 3～ 5ｃｍ ,但纱布的体积大 ,吸水量有限 ,不便于抢救成批烧伤患者和战时使用。笔者单位于 2 0 0 0年 3月～ 12月使用一种新型的敷料—复合碳纤维敷料 ,并将其与脱脂纱布进行了比较 ,结果表明前者具有吸水性强、重量轻、体积小     

纳米银敷料治疗烧伤创面的临床观察

目的 观察纳米银外用敷料对烧伤创面的治疗作用。方法 选择浅Ⅱ度及深Ⅱ度创面共116例，分别随机分为对照组54例(用皮维碘纱布换药)和治疗组62例(用皮维碘纳米银敷料换药)，观察创而渗出、炎症反应、浅Ⅱ度7d创面愈合率和深Ⅱ度创向14d创面愈合率、创面愈合时间，随访观察瘢痕增生情况，结果 与对照组比较，纳米银组创面下燥结痂快，炎症反应轻，创周炎症消退快。纳米银组：浅Ⅱ度7d愈合率68．4％，平均愈合时间8．3d；深Ⅱ度14d愈合率87．5％，平均愈合时间16．4d.对照组：浅Ⅱ度7d愈合率31．3％，平均愈合时间11．2d；深Ⅱ度14d愈合率59．1％，平均愈合时间19.8d。两组7d、14td愈合率和平均愈合时间比较差异均有显著性，随访10例瘢痕增生程度较轻。结论 纳米银是一种有效控制炎症反应，促进创面愈合的良好外用敷料，其能否减轻瘢痕增生尚需进一步观察。     

湿性敷料促进供皮区创面愈合的临床研究

目的　观察湿性敷料对供皮区创面愈合的作用。方法　对 4 2例患者行大腿外取皮 ,将供皮区创面分为治疗组即用湿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 (10 .2± 2 .7)天 ,对照组为 (12 .4± 1.5 )天 ,两者比较P <0 .0 1差异有显著意义。结论　湿性敷料能促进供皮区创面的愈合。     

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。     

AQUACEL-Ag亲水性纤维敷料在肛周脓肿术后创面愈合中的应用

目的观察AQUACEL-Ag亲水性纤维敷料对肛周脓肿患者术后创面愈合的作用。方法将49例肛周脓肿术后患者按随机数字表法随机分为试验组（25例）和对照组（24例）,分别予AQUACEL-Ag亲水性纤维敷料换药（1次/3 d）和无菌凡士林纱布换药（1次/d）,并观察2组患者的换药时创面疼痛程度、创面愈合时间、创面换药次数、创面愈合率及换药时创面分泌物培养结果。结果试验组在创面疼痛、愈合时间、创面换药次数及换药时分泌物培养转阴时间方面均优于对照组（P〈0.05）;动态监测创面愈合率：第3 d时2组间比较差异无统计学意义（P〉0.05）,第9、15、21 d时试验组创面愈合率明显高于对照组（P〈0.05）。结论从本组有限的数据看,AQUACEL-Ag亲水性纤维敷料对肛周脓肿患者术后创面愈合有重要作用。     

速愈乐创面敷料在骨科难愈性创面愈合中的应用

目的:分析速愈乐创面敷料在促进骨科难愈性创面愈合中的应用效果。方法:选择2021年3月-2022年3月笔者医院骨科收治的慢性难愈性创面患者79例作为观察对象,按随机数字表法分为试验组(n=40例,给予速愈乐创面敷料治疗)和对照组(n=39例,给予常规凡士林纱布外敷治疗)。比较两组治愈时间、换药次数、医疗费用、创面面积缩小率和愈合率、疼痛情况以及两组治疗效果,采用创面愈合评分表(Pressure ulcer scale for healing,PUSH)比较两组愈合效果。结果:试验组治愈时间短于对照组、换药次数少于对照组、医疗费用低于对照组,差异均有统计学意义(P<0.05);试验组创面面积缩小率和相对愈合速率均高于对照组(P<0.05),治疗后两组疼痛视觉模拟评分(Visual analogue scale,VAS)均低于治疗前,且试验组VAS评分低于对照组(P<0.05);试验组创面治疗有效率为95.00%,高于对照组的79.49%(P<0.05);治疗后两组PUSH评分均低于治疗前,且试验组治疗后不同时间点PUSH评分均低于对照组,存在组间、时间和交互意义(...     

Problem-adapted application of vacuum occlusion dressings: case report and clinical experience

Vacuum-assisted closure (VAC), a technique using subatmospheric pressure dressings, has been widely used for treatment of various chronic and complicated wounds. In addition to the advantages of an occlusive dressing therapy, the VAC therapy has proved effective in evacuating wound fluid, increasing tissue oxygen tension, decreasing bacterial contamination, and stimulating granulation tissue formation. This leads to more rapid re-epithelialization of wounds compared to conventional dressings. A two-phase VAC technique to provide enhanced coverage of an ischemic ulcer of the lower leg in a diabetic patient is presented. The refined VAC therapy scheme is described in detail and the results in a further 19 patients with complicated wounds of the lower leg and feet are reported. Received: 26 January 2000 / Accepted: 11 May 2000     

伤口敷料选择及其应用现状

对国内外敷料临床研究及指南进行综述,介绍理想伤口敷料的功能、各种常用敷料(接触性敷料、主动性敷料、被动敷料、互动性敷料、抗菌性敷料)的特性及伤口评估方法,为伤口敷料的选择提供参考。     

PPH加外痔切除术治疗重度混合痔的临床观察

目的:探讨PPH加外痔切除术治疗重度混合痔的临床应用.方法:PPH加外痔切除术治疗Ⅲ～Ⅳ度的混合痔患者35例与同期单纯PPH手术35例作比较研究.结果:两组在手术时间、术后并发症、术后住院时间方面没有显著性统计学差异(P＞0.05).结论:PPH加外痔切除术可拓展单纯PPH术手术适应证范围,提高患者满意度.     

Randomized clinical trial of honey-impregnated dressings for venous leg ulcers

Background:

The efficacy of honey as a treatment for venous ulcers has not been evaluated, despite widespread interest. This trial aimed to evaluate the safety and effectiveness of honey as a dressing for venous ulcers.

Methods:

This community‐based open‐label randomized trial allocated people with a venous ulcer to calcium alginate dressings impregnated with manuka honey or usual care. All participants received compression bandaging. The primary outcome was the proportion of ulcers healed after 12 weeks. Secondary outcomes were: time to healing, change in ulcer area, incidence of infection, costs per healed ulcer, adverse events and quality of life. Analysis was by intention to treat.

Results:

Of 368 participants, 187 were randomized to honey and 181 to usual care. At 12 weeks, 104 ulcers (55·6 per cent) in the honey‐treated group and 90 (49·7 per cent) in the usual care group had healed (absolute increase 5·9 (95 per cent confidence interval (c.i.) ? 4·3 to 15·7) per cent; P = 0·258). Treatment with honey was probably more expensive and associated with more adverse events (relative risk 1·3 (95 per cent c.i. 1·1 to 1·6); P = 0·013). There were no significant differences between the groups for other outcomes.

Conclusion:

Honey‐impregnated dressings did not significantly improve venous ulcer healing at 12 weeks compared with usual care. Registration number: ISRCTN 06161544 ( http://www.controlled‐trials.com ). Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.     

The safety and efficacy of dressings with silver - addressing clinical concerns

With the increasing use of silver as a topical application in wound care, concerns focussing on its role are bound to arise. These concerns, which centre on issues such as resistance and toxicity, clinical efficacy and cost-effectiveness, need to be addressed and openly discussed so that they are viewed from a rational perspective. While clinical efficacy and safety, along with cost-benefit, are of obvious interest, the origin of some of these concerns is a matter of debate. The silver-containing dressing segment of the medical device market is of huge commercial importance, and, consequently, marketing and promotional issues occasionally obscure the evidence that clinicians need to have in order that they may provide appropriate treatment for their patients. The impact of silver application on the wound bioburden needs to be examined carefully to heighten our awareness of any deleterious effects on the healing process, without inducing any unfounded anxieties.