生长激素在成人大面积深度烧伤的应用

目的探讨生长激素对成人烧伤创面愈合、感染的发病率,住院日以及预后的作用。方法选择1996年2月至1997年6月间,16例烧伤面积大于50％,Ⅲ度面积大于40％的重度烧伤患者,并随机分为重组人生长激素组(rHGH group)和对照组(control group),伤后当天及20天取外周血进行氨基酸谱分析,记录植皮区和供皮区创面愈合时间以及住院时间,计算伤后第30天全身创面愈合率。结果rHGH 组精神状态和食欲较好,血浆氨基酸谱分析,术后抗生素应用剂量及时间,植皮区和供皮区愈合时间,住院日等 rHGH 组均优于对照组。结论伤后早期开始使用 rHGH 有助于改善全身状况,促进创面愈合,减少并发症。     

生长激素在成人大面积深度烧伤的应用

目的探讨生长激素对成人烧伤创面愈合、感染的发病率，住院日以及预后的作用。方法选择１９９６年２月至１９９７年６月间，１６例烧伤面积大于５０％，Ⅲ度面积大于４０％的重度烧伤患者，并随机分为重组人生长激素组（ｒＨＧＨｇｒｏｕｐ）和对照组（ｃｏｎｔｒｏｌｇｒｏｕｐ），伤后当天及２０天取外周血进行氨基酸谱分析，记录植皮区和供皮区创面愈合时间以及住院时间，计算伤后第３０天全身创面愈合率。结果ｒＨＧＨ组精神状态和食欲较好，血浆氨基酸谱分析，术后抗生素应用剂量及时间，植皮区和供皮区愈合时间，住院日等ｒＨＧＨ组均优于对照组。结论伤后早期开始使用ｒＨＧＨ有助于改善全身状况，促进创面愈合，减少并发症     

进一步重视大面积深度烧伤皮肤替代物的研究

近半个世纪以来 ,烧伤外科学的基础研究和临床治疗发展迅速 ,取得了质的飞跃。可以认为 ,在这一过程中 ,烧伤外科学的发展经历了两次突破性革命。第 1次以我国 2 0世纪 5 0年代末大面积深度烧伤患者成功救治为代表 ,即突破了烧伤面积超过体表面积 80 %的病例不能治愈的界限 ,创     

大面积深度烧伤创面修复的新途径

大面积深度烧伤的创面修复贯穿烧伤治疗的全过程 ,是烧伤治疗的关键。只有及时、有效地覆盖创面 ,才能达到治疗的目的。由于大面积深度烧伤患者 (烧伤总面积 >90 %或Ⅲ度面积 >70 %TBSA)自体皮源缺乏 ,如何解决这一难题 ,多年来一直被人们所关注。196 6年上海第二医科大学瑞金医院烧伤科创建早期分批切痂自体皮与异体 (种 )皮混合移植法 ,将大张异体皮等距离开洞 ,嵌植断层自体小片皮 ,自体皮片的面积不小于 0 .3cm× 0 .3cm ,皮片间距不超过 1cm ,当自体皮片和异体皮片边缘吻合后 ,异体皮片出现脱屑现象 ,创面最终将随着自体皮片扩展而被…     

生长激素与烧伤

生长激素是体内重要的促合成代谢激素，研究证实生长激素有减弱甚至逆转严重应激后高代谢状态的作用。本文对生长激素的生物学特性及其在烧伤治疗叫的应用作一综述。     

大面积深度烧伤切削痂后皮肤混合移植法

In the early developing stage of burn surgery, severe burn patients with large and deep burn wound often died of complications because of shortage of auto-skin. The method of intermingled transplantation composed of a large sheet of partial thickness allo-skin with punched holes for inlaying small pieces of partial thickness auto-skin was first advocated by Chinese doctors (Rui in Hospital) in 1960's.This intermingled transplantation method has saved many severe burn patients with extensive full-thickness burn wound .The mortality rate of severe burn patients has decreased and the survival rate has increased remark ably since the intermingled transplantation treatment method used in the burn units. In this paper we review the process of formation of intermingled transplantation and the mechanisms of success of this Chinese method in repairing the large wound surface area after eschar excision. We will focus our discussion on the low systemic immunological reaction, the effect of auto-skin islet, local immunological tolerance induced by inlayed auto skin, the balance of Thl and Th2 cells and the effects of some cytokines such as IL-10 in local immunological tolerance and etc. after intermingled transplantation.     

大面积深度烧伤的创面修复

烧伤创面引起体液大量丢失、感染和一系列严重全身反应，是造成各种并发症和烧伤死亡的始动原因。因此创面修复是大面积烧伤治疗的根本问题。本文就大面积烧伤创面治疗的有关问题和研究进展作一介绍。     

大面积深度烧伤应用混合皮肤嵌植与微粒皮移植的比较

目的 了解大而积深度烧伤后混合皮肤嵌植与微粒皮移植疗效的差异. 方法 回顾性总结笔者单位1992-2008年17年间收治的101例大面积深度烧伤患者临床资料.将患者分为混合嵌植组52例、微粒皮组49例.比较2组患者首次自体供皮面积、首次自体皮覆盖创面面积,首次自体皮移植成活率、自体皮理论扩展倍数、自体皮实际扩展倍数、自体供皮总面积,以及术后残余创面情况、大关节功能状况等. 结果 混合嵌植组、微粒皮组的首次自体供皮面积分别为(3.25±0.48)%、(3.01±0.21)%TBSA,首次自体皮覆盖创面面积分别为(30.4±3.6)%、(41.4±1.3)%TBSA,首次自体皮移植成活率分别为(99.9±1.9)%、(87.5±6.8)%,自体皮理论扩展倍数分别为(9.5±1.3)、(13.9±1.4)倍,自体皮实际扩展倍数分别为(9.5±1.3)、(12.0±1.5)倍,上述指标组间比较,差异均有统计学意义(P<0.05);混合嵌植组、微粒皮组自体供皮总面积分别为(14.2±1.9)%、(14.0±2.1)%TBSA,2组比较,差异无统计学意义(P>0.05).混合嵌植组、微粒皮组残余创面超过0.5%TBSA者分别有23例占44.2%、37例占75.5%;混合嵌植组大关节功能状况较好者34例占65.4%,微粒皮组18例占36.7%. 结论 微粒皮移植法自体皮扩展倍数明显大于混合嵌植法,能更充分利用有限皮源;混合嵌植法创而愈合质量和大关节功能恢复状况优于微粒皮移植法.     

重组人生长激素在严重烧伤病人中的应用研究

目的 探讨生长激素对大面积烧伤病人蛋白质代谢、创面愈合能力、免疫功能及预后的作用。方法 选择４２例大面积烧伤病人,随机分为重组人生长激素治疗组和对照组,并分析比较两组一般状况、蛋白质代谢、创面愈合时间、免疫功能,结果 ｒｈＧＨ组一般情况良好,体重增加,血浆蛋白质水平,供皮区愈合时间及体液和细胞免疫功能均比对照组好。结论ｒｈＧＨ能有效促进蛋白质合成,缩短创面愈合时间,增强机体免疫能力,从而提高大面积     

重组人生长激素在严重烧伤病人中的应用研究

目的探讨生长激素对大面积烧伤病人蛋白质代谢、创面愈合能力、免疫功能及预后的作用。方法选择42例大面积烧伤病人,随机分为重组人生长激素(rhGH)治疗组和对照组,并分析比较两组一般状况、蛋白质代谢、创面愈合时间、免疫功能。结果 rhGH 组一般情况良好,体重增加,血浆蛋白质水平、供皮区愈合时间及体液和细胞免疫功能均比对照组好。结论 rhGH 能有效促进蛋白质合成,缩短创面愈合时间,增强机体免疫能力,从而提高大面积烧伤病人生存率。     

重组人生长激素在严重烧伤病人中的应用研究

目的探讨生长激素对大面积烧伤病人蛋白质代谢、创面愈合能力、免疫功能及预后的作用。方法选择４２例大面积烧伤病人,随机分为重组人生长激素（ｒｈＧＨ）治疗组和对照组,并分析比较两组一般状况、蛋白质代谢、创面愈合时间、免疫功能。结果ｒｈＧＨ组一般情况良好,体重增加,血浆蛋白质水平、供皮区愈合时间及体液和细胞免疫功能均比对照组好。结论ｒｈＧＨ能有效促进蛋白质合成,缩短创面愈合时间,增强机体免疫能力,从而提高大面积烧伤病人生存率。     

Recombinant human growth hormone accelerates wound healing in children with large cutaneous burns.

OBJECTIVE: Two forms of recombinant growth hormone that accelerate the healing of skin graft donor sites in severely burned children were evaluated. SUMMARY BACKGROUND DATA: Growth hormone has been shown to reduce wound healing times in burned pediatric patients. Through genetic engineering, several different forms have been synthesized; however, not all are marketed currently. Two forms of growth hormone were used in these studies, Protropin (Genentech, Inc., San Francisco, CA), a commercially available product that possesses a N-terminal methionine residue not found in the second form Nutropin (Genentech, Inc., San Francisco, CA), which, as yet, is not commercially available. Through the use of recombinant human growth hormone, rapid wound healing may reduce the hypermetabolic period, the risk of infection, and accelerate the healing of donor sites used for grafting onto burned areas. The two structurally different forms of growth hormone were tested for their efficacy in healing donor sites in severely burned children. METHODS: Forty-six children, with a > 40% total body surface area and > 20% total body surface area full-thickness burn were entered in a double-blind, randomized study to receive rhGH within 8 days of injury. Twenty received (0.2 mg/kg/day) Nutropin or placebo by subcutaneous or intramuscular injection beginning on the morning of the initial excision. Eighteen patients who failed the entry criteria for receiving Nutropin received Protropin therapeutically (0.2 mg/kg/day). Donor sites were harvested at 0.006 to 0.010 inches in depth and dressed with Scarlet Red impregnated fine mesh gauze (Sherwood Medical, St. Louis, MO). The initial donor site healing time, in days, was reached when the gauze could be removed without any trauma to the healed site. RESULTS: Donor sites in patients receiving Nutropin (n = 20) or Protropin (n = 18) healed at 6.8 +/- 1.5 and 6.0 +/- 1.5 (mean +/- SD) days, respectively, whereas those receiving placebo (n = 26) had a first donor site healing time of 8.5 +/- 2.3 days. Both groups receiving rhGH showed a significant reduction in donor site healing time compared with placebo at p < 0.01. When subgroups were compared, no difference in healing times could be shown with regards to age or time of admission after injury. CONCLUSION: Our results indicate that both forms of rhGH are effective in reducing donor site healing time compared with placebo and suggest that accelerating wound healing is of clinical benefit because the patients' own skin becomes rapidly available for harvest and autografting. With this increase in the rate of wound healing, the total length of hospital stay can be reduced by more than 25%.     

The effect of epidermal growth factor on wound healing in mice

The data presented in this paper focus attention on the possible evolutionary advantages of communal licking, based upon the delivery of wound healing factors in the saliva to an immediate local injury. It is suggested that epidermal growth factor (EGF) is one of these factors, as topical application of EGF to a standardized back wound in mice caged separately enhanced wound closure in both control and sialectomized animals. A sex difference in the wound closing response was evident from these studies. The testosterone dependence of EGF synthesis and its action on wound closure as well as its release upon α-adrenergic stimulation, make teleological sense, in a context of an acute response to injury caused by fighting. It is also suggested that prostaglandins released in injured tissue may modulate these acute effects of EGF, as prostaglandin inhibitors prevented EGF-induced closure. Since EGF is known to be a potent mitogen for murine fibroblast and epithelial cell lines, it may also participate in longer term effects integral to wound healing.     

The effect of topical hyperalimentation on wound healing rate and granulation tissue formation of experimental deep second degree burns in guinea-pigs

Revital , a product containing 19 amino acids, was applied to experimental deep second degree burns in guinea-pigs for 24 days, in order to assess the effect of this form of hyperalimentation on the healing process. Silver sulphadiazine cream served as the contralateral control standard. Epithelialization was faster in the silver sulphadiazine treated burn wounds, while contraction of both tested wounds proceeded at a similar rate. Revital significantly enhanced the formation of granulation and scar tissue in this burn wound model. These observations indicate that topical wound hyperalimentation promotes granulation tissue formation of experimental deep second degree burns in guinea-pigs.