A Simple Dressing Technique Following Dermofasciectomy and Full Thickness Skin Grafting of the Fingers in the Treatment of Severe Dupuytren’s Contracture

Dupuytren’s disease with severe finger contractures and recurrent contractures following previous surgery often have extensive skin involvement. In these severe cases, excision of the diseased chord along with the involved skin is a good option to reduce the risk of recurrance. The resulting skin defect can be covered with a full thickness skin graft (FTSG) or a cross finger flap. Cross finger flaps have donor finger morbidity and hence a full thickness graft is usually preferred. The FTSG extending to the midlateral margins on both sides of the finger reduces the risk of joint contracture due to graft shrinkage. Once the FTSG is sutured in place, the standard practice is to compress and secure the graft to its recipient bed with a tie-over dressing and this can be time consuming. We present a simple dressing technique to secure the FTSG without the need for a tie-over dressing.     

敷料更换的不同次数对穿刺引流术后穿刺口感染的影响

目的 研究敷料更换的不同次数对穿刺引流术后穿刺口感染的影响.方法 随机将该院2013年6月—2014年7月收治的100位进行穿刺引流术的患者分为两组,50例为A组,50例为B组. 为A组患者1周更换1次敷料,B组患者1周更换2次敷料. 对两组患者穿刺口感染的情况进行分析比较. 结果 A组患者穿刺口感染的几率显著低于B组(P<0.05),A组患者的病原菌定植率显著低于B组(P<0.05),两组患者导管相关性血流感染率差异无统计学意义(P>0.05). 结论 穿刺引流术后的患者1周更换1次敷料比较合理,既能降低患者术后穿刺口感染的几率,又能降低医护人员的工作量,但要注意在敷料发生松动或者潮湿时也要及时进行更换.     

压膜式间隙保持器的临床应用

目的:观察正压压膜式间隙保持器的临床应用特点和效果.方法:选择60例5.9～10岁的乳牙过早缺失的患儿,随机分为实验组和对照组,实验组用正压压膜式间隙保持器,对照组用带环式丝圈间隙保持器.分别从患者对保持器的接受程度、保持器的制作、椅旁操作时间、固位效果及其保持疗效和因保持器本身问题导致的复诊率进行对比研究,并对测量数据进行统计学处理.结果:两组患者在对保持器的接受程度、保持器的制作、椅旁操作时间、美观、防止对合牙过度伸长方面具有显著的差异,在固位效果及其保持疗效和因保持器本身问题的复诊率上有差异,但是差异没有显著性.结论:正压压膜式间隙保持器是一种美观舒适,制作简单,戴用便捷、固位好,疗效佳,便于观察恒牙萌出程度的间隙保持器,它为口腔医师进行保持缺隙治疗时提供了一种新的选择.     

乳腺癌改良根治术后自帖式敷料包扎刀口35例临床观察

目的:探讨乳腺癌改良根治术后自帖式敷料包扎刀口的临床效果。方法:将70例乳腺癌改良根治术患者随机分为两组,对创面不同包扎方式进行对比。结果:自帖式敷帖对术后创面包扎并发症少于传统绷带加压包扎方式。结论:自帖式敷帖包扎乳腺癌改良根治术后创面,能预防切口并发症的发生。     

永磁速愈贴对妇产科手术切口愈合的观察

目的探讨永磁速愈贴对切13的消肿止痛，促进伤口愈合和防止疤痕粘连与普通敷料进行对比观察。方法将住院行妇产科手术100例患者与同期住院的手术患者进行对比观察。结果永磁速愈贴切13愈合佳者84．0％，良好者13．0％，愈合差为3．0％，而普通敷料为28．0％、60．0％和12．0％，p〈0．01（x^2=63．660）。结论永磁速愈贴切口具有透气、保湿、促进伤口愈合、消肿、止痒，防止疤痕形成等作用。而普通敷料透气性差，保湿性差，术后切口有红肿、缝线反应、切口愈合时间长及切口局部愈合后有痛痒感。     

不同方法治疗压褥的临床效果比较

目的探讨不同方法治疗压疮的临床效果。方法将65例患者计Ⅱ～Ⅲ度溃疡84处按基本条件相当原则随机分成A、B、C三组，A组21例28处，伤口采用清创冲洗后，给予康惠尔水胶体敷料；B组23例30处，伤口采用湿润烧伤膏；C组21例26处，清创冲洗后，给予自制凡士林油纱敷料外敷溃疡面处。结果B组愈合率最高，且平均显效时间和愈合时间均较A、C两组明显缩短，且A、B组明显高于C组。结论采用清创冲洗后用湿润烧伤膏是治疗压疮较好的方法之一。     

Biological effects of static magnetic fields on the microcirculatory blood flowin vivo: a preliminary report

There have been few studies of the effect of static magnetic fields on microcirculatory haemodynamics in vivo. The rat skinfold transparent chamber technique was used, which provides an excellent means of observing and quantifying direct in vivo microvascular haemodynamic responses to static magnetic fields up to 8 T. An intravital videomicroscope was used to measure the changes in blood flow before and after exposure to a magnetic field for 20 min in a horizontal type superconducting magnet with a bore 100 mm in diameter and 700 mm long. After exposure, microcirculatory blood flow showed an initial increase for about 5 min followed by a gradual decrease and a return to the control value. It is hypothesised that these changes represent rebound hyperaemia following reduced blood flow during exposure.     

胶原“人工皮”的研制及其生物物理特性

胶原“人工皮”由聚乙烯膜、尼龙筛网和胶原组成。动物实验证明,胶原“人工皮”应用于创面,可减少死腔,增加与创面的粘附力,控制细菌侵入和防止液体丢失。该“人工皮”可以替代猪皮或尸体皮应用于外科手术     

Change in granulation tissue coverage and bacteriological load using Low Cost Negative Pressure Wound Therapy in acute musculoskeletal wounds

BackgroundLow cost Negative Pressure Wound Therapy (NPWT) dressings have been considered as an alternative to traditional daily dressings. There is scanty literature evaluating the change in the percentage area of wound covered by granulation tissue following application of low-cost NPWT. The change in the bacteriological flora following application of low-cost NPWT devices has also not been evaluated.MethodsPatients above the age of 18 years with acute musculoskeletal injuries of <3 weeks duration which underwent a surgical debridement and required subsequent wound coverage were included in the study. Area of the wound and the area covered by the granulation tissue as well as the bacteriological count were measured before and after application of NPWT. A low cost NPWT using wall mounted vacuum device was put on the patient giving a constant negative pressure of 125 mm of Hg for 2 days. The findings before and after application of NPWT were compared and analyzed using Wilcoxin Signed-rank test.Results21 patients with mean age of 35.52±15.075 were included. The pre-NPWT granulation tissue area ranged from 122 mm² to 8483 mm² with a mean of 1648.38 mm² (SD = 1933.866). The post-NPWT granulation tissue area ranged from 234 mm² to 7847 mm² with a mean of 2364.48 mm² (SD = 1857.716). The mean increase in granulation tissue was 716.1 mm².The pre-NPWT wound area ranged from 422 mm² to 10847 mm² with a mean of 4009.62 mm² (SD = 3026.209). The post-NPWT wound area ranged from 326 mm² to 9143 mm² with a mean of 3410.33 mm² (SD = 2636.206). The mean reduction in wound size was 599.29 mm².The pre-NPWT bacteriological count ranged from 3000/ml to 130000000/ml with a mean of 12616761.90/ml (SD = 29664589.37). The post-NPWT bacteriological count ranged from 1000/ml to 380000000/ml with a mean of 26401523.81/ml. The mean increase in bacteriological count was 13784761.91/ml.ConclusionThere was a statistically significant decrease in wound size (p = 0.001) and statistically significant increase in percentage area of granulation tissue coverage (p = 0.000) following low cost NPWT application. However there was no statistically significant increase in bacteriological clearance in these patients.     

聚氨酯抗菌创伤敷料的制备及其灭菌效果的研究

以自制的亲水性聚氨酯软泡沫为载体制备抗菌创伤敷料。对4种抗菌剂(超微二氧化钛粉末、磺胺嘧啶银、磺胺、硝酸银)进行了实验。采用预聚体法、填充法、浸渍法等3种方法将抗菌剂加载于聚氨酯敷料中，测试了抗菌敷料的抗菌性能并进行了比较。结果表明，4种抗菌剂制备的敷料均有抗菌效能。综合考虑抗菌敷料的抗菌性能、手感、颜色、掉粉等因素，将超微二氧化钛粉末、磺胺嘧啶银和磺胺3种抗菌剂，填充加载法制备抗菌创伤敷料，抗菌效果好，