疡愈涂剂对免疫抑制小鼠伤口愈合和IL-1β、TNF-α的影响

目的 研究疡愈涂剂对免疫抑制小鼠皮肤伤口愈合作用和对创面局部炎性反应的影响。方法 以氢化可的松处理小鼠造成免疫抑制状态,采取全厚皮切除术,复制愈合迟缓伤口模型。随机分为对照组、模型组和疡愈涂剂高、中、低浓度组。治疗组伤口外用疡愈涂剂,一次性无菌敷料贴包扎,隔日换药。观察小鼠创伤后3、7和10天伤口面积; HE染色观察创面的组织学变化;放免法检测创面白细胞介素1（IL-1β）和肿瘤坏死因子α（TNF-α）水平。结果 用药后7天和10天与模型组比较,疡愈涂剂能够明显缩小免疫抑制小鼠创面面积（P<0.01,P<0.05）,组织学结果显示疡愈涂剂促进创面成纤维细胞增殖和血管生成。用药后3天时疡愈涂剂各浓度组IL-1β水平明显高于模型组（P<0.01）,7天时无明显差异,10天时高、中浓度组明显下降（P<0.01,P<0.05）。与模型组比较,疡愈涂剂各浓度组3天时TNF-α水平差异无统计学意义,7天时明显升高,10天时疡愈涂剂中、低浓度组明显下降（P<0.01）。结论 疡愈涂剂能促进免疫抑制小鼠皮肤伤口愈合,其机制可能是早期促进创面炎性反应来启动创面的修复,中晚期抑制炎性反应,促进肉芽组织生成。     

美宝创疡贴包扎治疗小儿足、踝辗挫伤56 例体会

目的　总结美宝创疡贴治疗小儿足、踝部辗挫伤的临床疗效, 分析美宝创疡贴治疗小儿足、踝部辗挫伤优越性。方法　根据小儿足、踝辗挫伤的特点, 对56 例小儿足、踝辗挫伤采用美宝创疡贴包扎治疗, 隔日或3 日换药1 次, 观察其治疗效果。结果　经门诊治疗2 ~3 次后, 绝大部分创面皮肤逐渐红润, 轻者5 d ~7 d即愈合, 重症或感染者均在2 ~3 周内愈合, 仅1 例患儿就诊时创伤超过1 周, 创面感染, 经4 周治疗后愈合。多数患儿经治疗后无瘢痕形成; 少数患儿患处出现散在性花斑样瘢痕, 但薄软, 有弹性, 关节功能均未受限。结论　本疗法可替代传统用凡士林油纱或其他方法治疗足、踝部皮肤辗挫伤, 效果良好。     

家属协同模式护理对瘢痕子宫手术患者切口愈合及美观满意度的影响

目的 分析对瘢痕子宫手术患者应用家属协同护理模式的效果及对切口愈合及满意度的影响。 方法 选择2023年1月-10月于我院行手术治疗的62例瘢痕子宫患者为研究对象,按随机数字表法分为对 照组和观察组,每组31例。对照组实施围术期常规护理,观察组在对照组的基础上实施家属协同护理 模式,比较两组切口瘢痕愈合情况、美观满意度及自护能力。结果 观察组切口甲级愈合占比高于对 照组,乙级、丙级愈合占比低于对照组,差异有统计学意义（P ＜0.05）;观察组美观满意度高于对照 组,差异有统计学意义（P ＜0.05）;观察组责任感、概念、机能评分均高于对照组,差异有统计学意 义（P ＜0.05）。结论 对瘢痕子宫手术患者应用家属协同护理模式的效果良好,可促进切口愈合,改善 切口美观性,有利于提升患者的自护能力,提高其美观满意度。     

Electrical microcurrent stimulation therapy for wound healing: A meta-analysis of randomized clinical trials

BackgroundElectrical microcurrent therapy (EMT) consists of the application of low intensity (μA) currents that are similar to endogenous electric fields generated during wound healing.AimsTo examine the effectiveness and safety of EMT for improving wound healing and pain in people with acute or chronic wounds.MethodRandomized clinical trials (RCTs) assessing the effectiveness of EMT in wound healing published up to August 1st, 2020 were included. The main outcomes were wound surface area, healing time, and number of wounds healed. Secondary outcomes were pain perception and adverse events. A quantitative analysis was conducted using the inverse variance and Mantel-Haenszel methods.ResultsEight RCTs were included in the qualitative summary and seven in the quantitative analysis (n = 337 participants). EMT plus standard wound care (SWC) produced a greater decrease in wound surface [mean difference (MD) = -8.3 cm²; CI 95%: ?10.5 to ?6.0] and healing time (MD = -7.0 days; CI 95%: ?11.9 to ?2.1) that SWC alone, showing moderate and low certainty in the evidence, respectively. However, no differences were observed in the number of healed wounds [risk ratio = 2.0; CI 95%: 0.5 to 9.1], with very low quality of evidence. EMT decreased perceived pain (MD = -1.4; CI 95%: ?2.7 to ?0.2), but no differences in adverse effects were noted between groups (risk difference = 0.05; CI 95%: ?0.06 to 0.17).ConclusionsEMT is an effective, safe treatment for improving wound area, healing time, and pain. Further clinical trials that include detailed intervention parameters and protocols should be designed to lower the risk of bias.     

Effectiveness of negative-pressure wound therapy compared to wet-dry dressing in pressure injuries

This study aims to compare the effects of Negative-Pressure Wound Therapy (NPWT) and wet-to-dry dressing on Stages 3 and 4 pressure injuries (PI), This study is a randomized controlled trial. A total of 30 patients with Stages 3 and 4 pressure injuries were included in the study. The patients were divided into two groups: NPWT group and the wet-to-dry dressing group. All patients received 3 rounds of treatment. Data were collected with a Patient Identification Form, Pressure Ulcer Scale for Healing (PUSH) Tool and the findings of the Three-Dimensional Wound Measurement (3DWM) device. We found that granulation tissue formation was more significant in the experimental group (p < .05), and that there was more significant wound shrinkage (p < .05) with a more significant decrease in the PUSH Tool scores (p < .05). The wounds were assessed with the tool and the 3DWM system. Device measurements were found to be correlated with PUSH Tool findings (p < .05). There was a significant correlation between device-measured granulation findings and PUSH Tool score results of the experimental group's third measurements (p < .05). We conclude that NPWT is an effective treatment method for pressure injuries, and 3DWM device is a useable wound assessment tool.     

苦参汤熏洗联合马应龙麝香痔疮膏治疗混合痔术后疗效研究

目的:探讨苦参汤熏洗联合马应龙麝香痔疮膏在混合痔(MH)术后的应用效果。方法:按入院顺序将85例MH术后患者分为两组,对照组(n=42)予马应龙麝香痔疮膏治疗,联合组(n=43)予苦参汤熏洗联合马应龙麝香痔疮膏治疗。2周后,比较两组疗效、伤口疼痛及愈合情况,测定创面组织血管内皮生长因子(VEGF)、碱性成纤维生长因子(bFGF)、肛门功能。结果:联合组总有效率95.35% 高于对照组78.57%(P<0.05)。治疗后,两组主观疼痛视觉模拟(VAS)评分、创面渗液积分、肉芽形态积分、肛管高压带长度、Wexner评分明显降低,而创面愈合率、创面组织VEGF、bFGF水平、肛管最大收缩压、肛管舒张压、肛管静息压明显升高,且联合组各项指标降低或升高幅度大于对照组,差异有统计学意义(均P<0.05)。结论:苦参汤熏洗联合马应龙麝香痔疮膏能加快MH术后创面愈合,缓解术后疼痛症状,促进肛门功能恢复,其机制可能与上调创面组织中VEGF、bFGF表达有关。     

促愈熏洗方对肛瘘术后患者创面愈合及创面肉芽组织的影响

目的:观察促愈熏洗方对肛瘘术后创面愈合的临床疗效及创面肉芽组织中共刺激分子(CD86)、甘露糖受体1(CD206)、白介素-1β(IL-1β)表达的影响。方法:将93例肛瘘术后患者按随机数字表法分对照组(n=47)、观察组(n=46); 对照组接受痔疾洗液坐浴熏洗治疗,观察组接受促愈熏洗方坐浴熏洗治疗; 比较两组疗效、创面愈合率,记录创面疼痛、创缘水肿、创面分泌物情况,并检测两组创面肉芽组织中CD86、CD206、IL-1β表达及血清干扰素-γ(IFN-γ)、诱导型一氧化氮合酶(iNOS)、转化生长因子-β(TGF-β)水平。结果:两组疗效等级比较差异有统计学意义(P<0.05); 术后14、21、28 d观察组创面愈合率高于对照组(P<0.05); 与术后1 d比较,两组术后3、7、14 d的创面疼痛评分、创缘水肿评分、创面分泌物评分显著下降,观察组低于对照组(P<0.05); 观察组肉芽组织中CD86、IL-1β表达较对照组显著减弱,肉芽组织中CD206表达显著增强; 术后14 d,两组IFN-γ、iNOS水平显著下降、TGF-β水平均上升,观察组术后14 d IFN-γ、iNOS水平显著低于对照组,TGF-β水平高于对照组(P<0.05)。结论:促愈熏洗方用于肛瘘术后创面可提高疗效,改善创面局部免疫状态,抑制炎症反应,更利于创面愈合。     

A comparison of barbed and smooth sutures for ovine cesarean delivery

Objective

To determine the adequacy of barbed and smooth sutures for closing the uterus and fascia in pregnant ewes.

Methods

Nine ewes that underwent cesarean delivery were randomized to each receive 2 different suture materials for both the uterus and the fascia. The sutures used were: barbed poliglecaprone 25, smooth poliglecaprone 25, braided polyglactin 910, and smooth chromic sutures on the uterus; and barbed polydioxanone (PDO), barbed poliglecaprone 25, braided polyglactin 910, and smooth chromic sutures on the fascia.

Results

In 4 of the ewes, the fascia suture line failed prematurely, leading to dehiscence prior to planned euthanasia and necropsy. The remaining 5 ewes were euthanized on days 2, 7, or 28. All suture materials (smooth and barbed) were adequate for uterine closures. Barbed PDO, smooth poliglecaprone 25, and braided polyglactin 910 were adequate for fascia closures, whereas both barbed poliglecaprone 25 and smooth chromic resulted in premature suture line ruptures and fascia dehiscence.

Conclusion

In a small pilot study, absorbable knotless barbed suture was adequate and equivalent to absorbable knotted smooth suture for closing the uterus following ovine cesarean delivery. On the rectus fascia, however, sutures—whether barbed or smooth—with lower tensile strength resulted in fascial dehiscence.     

Spectroscopic and chromatographic evidences of NADPH in human placental extract used as wound healer

An aqueous extract of human placenta, which is used as wound healer, has been investigated in terms of fluorescence properties. When excited at 340 nm, it results in fluorescence emission having maxima around 436 nm, which is fairly specific for nicotinamide adenine dinucleotide, reduced form (NADH) and nicotinamide adenine dinucleotide phosphate, reduced form (NADPH). The excitation spectra, having emission at 440 nm, show patterns comparable to these nucleotides. Thin layer chromatography and reversed-phase (RP) HPLC confirm presence of only NADPH in the extract. The emission and excitation patterns of NADPH purified after HPLC resemble exactly with the reference compound. Its content has been estimated to be 0.018±0.003 mg/ml based on fluorescence emission with respect to a standard calibration curve (n=6). Biological functionality of NADPH in the extract has been confirmed by glutathione reductase assay (n=5).     

Topical continuous use of Lippia sidoides Cham. essential oil induces cutaneous inflammatory response,but does not delay wound healing process

Ethnopharmacological relevance

The essential oil of Lippia sidoides (EOLS) has been used in Brazilian folk medicine as a topical antiseptic agent in skin for treatment of wounds and superficial infections of the body. The aim of this study was to investigate the effects of EOLS on intact and damaged skin, including its action on expression of mediators, COX-2 and VEGF, involved in healing full-thickness cutaneous lesions in vivo.

Material and methods

EOLS was analyzed chemically and used at different concentrations to dose-response experiments in skin mice. Skin irritation tests by one-dosage and multiple-dosages and irritation to damaged skin were assessed by macroscopy, morphometry and histological and immunohistochemical analyses. To evaluate the effects of EOLS on wound healing, excision wounds were surgically created on the dorsum of rats, and the ointments at 6% and 12% were applied daily to the wound area. Cutaneous lesions were assessed by planimetric (wound contraction) and macroscopic parameters.

Results

Skin irritation tests showed that topical application of EOLS promoted cutaneous inflammation in varying degrees, which was demonstrated by increase of skin thickness and formation of cutaneous edema and erythema. Topical administration of EOLS in high concentrations presented an irritant response to skin, but this irritation is lighter when low concentrations this oil were used. Histological evaluation supported the outcome of these models, which revealed accentuated presence of inflammatory cells infiltration. In wound healing process, the lesions treated with EOLS showed intense edema and exsudation up to day 5, but there were not significant differences in the wound contraction on days 14 and 21. No immunohistochemical staining was verified to COX-2 and VEGF mediators in skin treated with EOLS 12%.

Conclusion

The continuous application of EOLS in adequate concentrations on cutaneous wounds increases inflammatory response without delay the lesions closure. The association of these results with antimicrobial action previously related to EOLS allows its indication as an alternative therapeutic modality for topical treatment of infected cutaneous wound. Nevertheless, further studies need to be performed to determine the mechanism of action and support its application in clinical practice.