3M液体敷料在治疗癌症晚期患者失禁性皮炎中的应用

目的 探讨3M Cavilon液体敷料在治疗癌症晚期患者大小便失禁所致失禁性皮炎的应用效果.方法 将84例大小便失禁的癌症晚期患者随机分成观察组42例和对照组42例.对照组采用常规皮肤护理,观察组在常规护理的基础上使用3M液体敷料进行皮肤护理,观察二组皮肤护理的效果.结果 使用3M液体敷料治疗组疗效明显优于常规护理组,二组比较差异有统计学意义(P＜0.05),失禁性皮炎的愈合时间短于对照组,二组比较差异有统计学意义(P＜0.05).结论 3M液体敷料的应用可有效的隔离排泄物对皮肤的刺激,尽早使用可以使大小便失禁患者保持皮肤完整性,减少了晚期癌症患者由于失禁性皮炎导致的疼痛和不适.     

负压封闭引流治疗糖尿病足疗效分析

【摘要】 目的 探讨负压封闭引流治疗糖尿病足的临床疗效。方法 选取2017年12月至 2019年12月郑州大学附属郑州中心医院收治的74例糖尿病足患者作为研究对象,按照随机数表法将其随机分为观察组(37例)和对照组(37例)?观察组患者局部创面采用负压封闭引流治疗,对照组患者局部创面采用多功能敷料治疗,对比两组患者临床疗效、换药次数以及创面愈合时间。结果 治疗4周后,观察组患者中治愈34例、好转3例,明显优于对照组患者的治愈 25 例、好转12例 (Z = -2.585,P =0.010)。观察组患者换药次数为 (8.16±1.61) 次,明显少于对照组患者的换药次数 (12.67±2.50) 次 (t = 9.226,P < 0.001); 创面愈合时间为(33.06±6.40) d,明显短于对照组患者的创面愈合时间 (47.58±6.72) d (t =9.517,P <0.001)。结论 采用负压封闭引流治疗糖尿病足,可有效减少换药次数,缩短创面愈合时间,疗效显著。     

湿润烧伤膏联合3M液体敷料治疗新生儿尿布皮炎的效果观察

目的:探讨湿润烧伤膏联合3M液体敷料治疗新生儿尿布皮炎的临床疗效。方法:对我院110例新生儿尿布皮炎患儿进行临床对照试验研究,使用硬币投掷法将患儿随机分为对照组(单独使用湿润烧伤膏)和试验组(湿润烧伤膏联用3M液体敷料),比较两组患儿治疗3 d时临床疗效、疼痛程度及不良反应。结果:试验组患儿创面愈合时间显著低于对照组患儿(P<0.05);试验组患儿疼痛程度2级、3级、4级人数少于对照组;两组患儿临床疗效比较,试验组治愈人数显著高于对照组(P<0.05);试验组患儿皮肤机械性损伤、继发过敏性皮炎的发生率显著低于对照组患儿(P<0.05)。结论:湿润烧伤膏联合3M液体敷料治疗新生儿尿布皮炎的临床疗效明显,可以显著改善患儿疼痛状况,减少临床不良事件发生率。     

Wound dressing composed of hyaluronic acid and collagen containing EGF or bFGF: comparative culture study

We developed a novel wound dressing composed of a hyaluronic acid (HA) and collagen (Col) spongy sheet containing epidermal growth factor (EGF) or basic fibrolast growth factor (bFGF) by freeze-drying method (EGF-wound dressing or bFGF-wound dressing, respectively). A wound dressing without any growth factor was prepared as a control in a similar manner as above (C-wound dressing). Intermolecular cross-linkage between Col molecules was induced by UV irradiation. The release behavior of free HA from the wound dressing was investigated using a C-wound dressing. The weight of C-wound dressing after 1 day, 3, 5, and 7?days of incubation on top of a Col gel sheet at the air–water interface (wound surface model) was 55, 36, 30, and 19% of the original weight, respectively. Most free HA and a part of Col was released from the cross-linked Col network in the wound dressing during incubation, as the original Col content in the wound dressing was 33%. Next, fibroblast proliferation was assessed in conventional culture medium preconditioned by immersion of a piece of C-, EGF-, or bFGF-wound dressing, i.e. C-conditioned medium, EGF-conditioned medium, or bFGF-conditioned medium. Cell proliferation in C-conditioned medium increased to approximately the same level as that in conventional medium. Cell proliferation in EGF- and bFGF-conditioned medium was 1.9 times and 2.6 times greater than that in conventional medium after 7?days of cultivation, respectively. Finally, cytokine production of fibroblasts was assessed in a wound surface model using a fibroblast-incorporating Col gel sheet (cultured dermal substitute [CDS]). CDS was elevated to the air–medium interface, on which each wound dressing was placed and cultured for 7?days. Fibroblasts in CDS covered with EGF-wound dressing released 3.6 times more vascular endothelial growth factor (VEGF) and 4.6 times more hepatocyte growth factor (HGF) when compared with the C-wound dressing. Fibroblasts in CDS covered with bFGF-wound dressing released 10.2 times more VEGF and 6.3 times more HGF when compared with the C-wound dressing. This finding indicates that bFGF-wound dressing can facilitate more effectively the VEGF and FGF production compared with EGF-wound dressing.     

Polyvinyl pyrrolidone/carrageenan blend hydrogels with nanosilver prepared by gamma radiation for use as an antimicrobial wound dressing

Hydrogels were prepared using polyvinyl pyrrolidone (PVP) blended with carrageenan by gamma irradiation at different doses of 25 and 40 kGy. Gel fraction of hydrogels prepared using 10 and 15% PVP in combination with 0.25 and 0.5% carrageenan was evaluated. Based on gel fraction, 15% PVP in combination with 0.25% carrageenan and radiation dose of 25 kGy was selected for the preparation of hydrogels with nanosilver. Radiolytic synthesis of silver nanoparticles within the PVP hydrogel was carried out. The hydrogels with silver nanoparticles were assessed for antimicrobial effectiveness and physical properties of relevance to clinical performance. Fluid handling capacity (FHC) for PVP/carrageenan was 2.35 ± 0.39–6.63 ± 0.63 g/10 cm² in 2–24 h. No counts for Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Candida albicans were observed in the presence of hydrogels containing 100 ppm nanosilver after 3–6 h. The release of silver from hydrogels containing 100 ppm nanosilver was 20.42 ± 1.98 ppm/100 cm² in 24 h. Hydrogels containing 100 ppm nanosilver with efficient FHC demonstrated potential microbicidal activity (≥3 log₁₀ decrease in CFU/ml) against wound pathogens, P. aeruginosa, S. aureus, E. coli, and C. albicans. PVP/carrageenan hydrogels containing silver nanoparticles can be used as wound dressings to control infection and facilitate the healing process for burns and other skin injuries.     

Pectin-chitosan-PVA nanofibrous scaffold made by electrospinning and its potential use as a skin tissue scaffold

Scaffolds made of chitosan nanofibers are often too mechanically weak for their application and often their manufacturing processes involve the use of harmful and flammable organic solvents. In the attempt to improve the mechanical properties of nanofibrous scaffolds made of chitosan without the use of harmful chemicals, pectin, an anionic polymer was blended with chitosan, a cationic polymer, to form a polyelectrolyte complex and electrospun into nanofibers for the first time. The electrospun chitosan-pectin scaffolds, when compared to electrospun chitosan scaffolds, had a 58% larger diameter, a 21% higher Young’s modulus, a 162% larger strain at break, and a 104% higher ultimate tensile strength. Compared to the chitosan scaffolds, the chitosan-pectin scaffolds’ swelling ratios decreased by 55% after 60?min in a saline solution and more quickly released the preloaded tetracycline HCl. The L929 fibroblast cells proliferated slightly slower on the chitosan-pectin scaffolds than on the chitosan scaffolds. Nonetheless, cells on both materials deposited similar levels of extracellular type I collagen on a per DNA basis. In conclusion, a novel chitosan-pectin nanofibrous scaffold with superior mechanical properties than a chitosan nanofibrous scaffold was successfully made without the use of harmful solvents.     

Controlling Fibroblast Proliferation with Dimensionality-Specific Response by Stiffness of Injectable Gelatin Hydrogels

Abstract

We report an injectable hydrogel system with tunable stiffness for controlling the proliferation rate of human fibroblasts (HFF-1) in both two-dimensional (2D) and three-dimensional (3D) culture environments for potential use as a wound dressing material. The hydrogel composed of gelatin–hydroxyphenylpropionic acid (Gtn–HPA) conjugate was formed by the oxidative coupling of HPA moieties catalyzed by hydrogen peroxide (H₂O₂) and horseradish peroxidase (HRP). The stiffness of the hydrogels was controlled well by varying the H₂O₂ concentration. The effects of hydrogel stiffness on the proliferation rate of HFF-1 in both 2D and 3D were investigated. We found that the proliferation rate of HFF-1 using Gtn–HPA hydrogels was strongly dependent on the hydrogel stiffness, with a dimensionality-specific response. In the 2D studies, the HFF-1 exhibited a higher proliferation rate when the stiffness of the hydrogel was increased. In contrast, the HFF-1 cultured inside the hydrogel remained non-proliferative for 12 days before a stiffness-dependent proliferation profile was shown. The proliferation rate decreased with an increase in stiffness of the hydrogel in a 3D culture environment, unlike in a 2D environment.     

Porosity and biological properties of polyethylene glycol-conjugated collagen materials

Collagen-based materials can be designed for use as scaffolds for connective tissue reconstruction. The goal of the present study was to evaluate the behavior of collagen materials as well as cell and tissue reactions after the conjugation of activated polyethylene glycols (PEGs) with collagen. It is known that proteins conjugated with PEGs exhibit a decrease in their biodegradation rate and their immunogenicity. Different concentrations and molecular weights of activated PEGs (PEG-750 and PEG-5000) were conjugated to collagen materials (films or sponges) which were then investigated by collagenase assay, fibroblast cell culture, and subcutaneous implantation. PEG-conjugated collagen sponge degradation by collagenase was delayed in comparison to untreated sponges. In culture, fibroblasts with a normal morphology reached confluency on PEG-conjugated collagen films. In vivo, the porous structure of non-modified sponges collapsed by day 15 with a few observable fibroblasts between the collagen fibers. In PEG-modified collagen sponges, the porous structure remained stable for 30 days. Cell infiltration was particularly enhanced in PEG-750-conjugated collagen sponges. In conclusion, PEGs conjugated onto collagen sponges stabilize the porous structure without deactivating the biological properties of collagen. These porous composite materials could function as a scaffold to organize tissue ingrowth.     

湿性敷料联合持续微氧渗透创面治疗技术在慢性伤口中的应用效果

目的:探讨湿性敷料联合持续微氧渗透创面治疗技术在慢性伤口中的应用效果。方法:选择2019年3月—2020年3月在某院治疗的慢性伤口病人27例,随机分为对照组13例和观察组14例。根据两组病人住院期间的病情特点拟订个体化的治疗方案,对照组使用湿性愈合伤口管理方法对伤口进行管理,观察组在此基础上应用持续微氧渗透创面治疗技术伤口管理方法对伤口进行管理。治疗1个疗程即28 d后比较两组病人伤口的愈合程度、伤口治疗有效时间、28 d内伤口换药次数及伤口的疼痛程度。结果:观察组病人治疗1个疗程后伤口愈合程度明显优于对照组,伤口治疗有效时间明显短于对照组,换药次数明显少于对照组(P<0.01)。观察组病人治疗第14天、第28天的VAS评分明显低于对照组(P<0.01)。结论:湿性敷料联合持续微氧渗透创面治疗技术可明显提高慢性伤口的愈合率,有效缓解疼痛,缩短愈合时间。     

Protection of an intraoral surgical wound with a new dressing: a randomised controlled clinical trial

Operations that involve the maxillofacial region often require intraoral incisions, and contamination of these wounds is common as a result of the presence of saliva, plaque, and food debris. Postoperative infection is therefore common. The aim of the study was to evaluate the clinical efficacy of an intraoral dressing material, Reso-Pac®, in improving postoperative comfort for patients and its effect on wound healing. One hundred patients who required removal of impacted mandibular third molars were recruited, and were randomised into two groups (50 in each). A standardised surgical technique was used for removal of the impacted teeth, and wounds were closed with sutures. Postoperatively, the study group was given Reso-Pac® dressing while the control group was not. Postoperative pain was measured using a visual analogue scale (VAS). Wound healing was assessed with the help of Landry’s scale, and we also measured thermal sensitivity. Data were analysed using the paired t test. The results in the study group were significantly better than those in the control group (p < 0.001). Reso-Pac® promoted wound healing and improved patients’ comfort during the postoperative phase.