摘要:目的:总结胸心血管外科慢性伤口换药的经验。方法：2008年11月2009年4月我科共发生12例手术切口裂开病例，使用贝复济喷洒创面，藻酸钙敷料填塞创面，外用二层敷料固定，根据渗液情况决定更换敷料的频率，高渗出时每天更换，中等渗出时每2天更换，少量渗出时每3天更换。结果：本组12例患者，11例患者伤口均达到二期愈合，平均愈合时间为（12±2）天，另外1例转烧伤科行植皮术，后愈合。结论：通过联合使用贝复济和藻酸钙敷料，使本组病例的渗出减少，创面肉芽生长迅速，伤口疼痛减轻或消失，伤口周围皮肤免受浸渍，伤口快速愈合。Abstract: Objective: To introduce the methods of using streptogenin spray and the alginate dressing on Cardiac wound disruption. Methods: Our department had 12 cases of wound disruption from the November 2008 to the April 2009, We sprinkled the streptogenin spray to wound, then filled wound with the alginate dressing, finally fix wound with gauze and adhesive tape.According to the volume of the exudation, we decided how often to change the dressings. When the exudation volume was high ,We changed the dressing every day; While medium, We changed every two days ; When low ,We changed every three days. Results:Eleven 11 of 12 wounds got second phase of healing, the average healing time was (12±2) days. Conclusion: Using of the Streptogenin spray and the alginate dressing on disruption wound can reduce the exudation volume and wound pain, meanwhile it can progress the growth of granulation , so the wounds healed quickly.
Bacterial biofilm is the key problem of chronic wound infection and difficult healing. How to prevent and control bacterial biofilm and improve the prognosis of chronic wound has become a research hotspot in the field of wound care. This paper will summarize from the following aspects: four major stages in the process of chronic wound bacteria biofilm formation (surface adhesion, formation of small colonies, biofilm maturation, and dispersion and separation); characteristics of host immune response in the presence of biofilms; morphological, microbiological, and molecular detection methods for biofilms; and progress in in vitro trials, animal trials, clinical trials, and new therapeutic methods of biofilm. The purpose of this review is to provide evidence for the treatment of biofilms for chronic wounds.
Chronic wounds have a high incidence and a long course of disease, and will bring a heavy economic burden to patients, which is the difficulty of clinical treatment at present. Therefore, it is urgent to find an effective method to promote chronic wound healing. In recent years, the application of therapeutic ultrasound in chronic wound treatment has gradually gained attention, and has become a promising adjuvant therapy. This article reviews the process of wound healing, the mechanism of therapeutic ultrasound in promoting wound healing, the biological effects of therapeutic ultrasound in different stages of wound healing and its application in diabetic ulcer, venous ulcer of lower limbs and pressure ulcer, in order to provide new ideas and directions for the treatment of chronic wounds.
Slow wound healing has been a troublesome problem in clinic. In China, traditional methods such as antibiotics and silver sulfadiazine are used to treat skin wound, but the abuse use has many disadvantages, such as chronic wounds and pathogen resistance. Studies have shown that the microorganisms with symbiotic relationship with organisms have benefits on skin wound. Therefore, the way to develop and utilize probiotics to promote wound healing has become a new research direction. In this paper, we reviewed the studies on the bacteriotherapy in the world, described how the probiotics can play a role in promoting wound healing through local wound and intestine, and introduced some mature probiotics products and clinical trials, aiming to provide foundations for further development of bacteriotherapy and products.
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.