慢性疮面之“去腐生肌”的再认识

“去腐生肌”具有独特临床疗效和鲜明中医特色,是慢性疮面治疗过程中的一种重要手段,但目前对“去腐生肌”的认识存在一定局限性且不全面。结合文献及临床实践,将“去腐生肌”重新定义为“去除一切阻碍疮面愈合的增多或新生病理产物,创造有利于或促进疮面愈合的疮面状态或新生产物的过程”。该定义全面考虑了去腐生肌所涉及的有形之腐和无形之腐、有形之肌和无形之肌之间的相互关系,并认为去腐与生肌之间存在“去腐生肌-肌生腐去-腐去肌生”这一动态过程,即去腐是生肌的必然条件,生肌是去腐的最终结果,临床中可依据具体情况选择不同的内治、外治手段来实现去腐和生肌。通过重新认识去腐生肌,以期为慢性疮面治疗提供新的思路。

Re-recognition of Eliminating Necrotic Tissues and Promoting Granulation of Chronic Wounds

The treating principle of eliminating necrotic tissues and promoting granulation has presented unique clinical efficacy and distinctive characteristics of traditional Chinese medicine(TCM).Meanwhile,it is a significant method in treating chronic wounds.However,the current understanding has certain limitations and is not comprehensive.Based on literature review and clinical practice,this research gives it the definition:the process of removing all excessive or new pathological product that hinders the healing of sores,creating the wound condition or new product that is conducive to or promotes wound healing.This definition takes into account the interrelationship between the tangible necrotic tissues and the invisible necrotic tissues,the tangible muscle and the invisible muscle involved in eliminating necrotic tissues and promoting granulation.In addition to that,it summarizes the dynamic process of eliminating necrotic tissues and promoting granulation,re-generation of flesh triggering elimination of necrotic tissues and elimination of necrotic tissues promoting flesh growth.To be more specific,elimination of necrotic tissues is the inevitable condition of flesh growth and flesh growth is the result of elimination of necrotic tissues.In clinic practice,different internal and external treatments can be selected according to specific conditions to achieve the goal of eliminating necrotic tissues and promoting granulation.This research aims at sparking new thoughts for the treatment of chronic wounds by means of re-recognition eliminating necrotic tissues and promoting granulation.