烧伤残余创面的序贯性治疗
Sequential management of residual wounds in burn patients
王甲汉 1李志清 1陈静 1任加良 1邱学文1
作者信息
- 1. 510515,广州,南方医科大学南方医院烧伤科
- 折叠
摘要
目的 寻找烧伤残余创面序贯性治疗的有效方法.方法 选择烧伤残余创面患者25例,采取自身对照,分别以凡士林油纱(A组)、组织工程全层皮肤(HTAS,B组)覆盖创面,用含氧液冲洗、负压引流后覆盖HTAS(C组).取创面标本检测细菌量、肿瘤坏死因子(TNF)α含量及基质金属蛋白酶(MMP)13 mRNA表达水平,计算创面愈合率.结果 治疗后第3、6、9、12天,患者C组创面细菌量分别为(5.30±1.60)、(1.30±0 80)、(1.70±0.60)和(0.60±0.10)集落形成单位(CFU)/ml,显著低于A、B组(P＜0.01).C组创面经治疗后6 d,TNF-α含量和MMP-13 mRNA表达水平分别为(0.650±0.040)ng/mg、0.210±0.010,明显低于A组[(1.550±0.370)ng/mg、1.040±0.050,P＜0.01]和B组[(0.810±0.080)ng/mg、0.640±0.030,P＜0.01];B组肉芽组织TNF-α含量和MMP-13 mRNA表达量显著低于A组(P＜0.01).治疗后15、30 d,C组创面愈合率明显高于A、B组(P＜0.01).结论 应用含氧液冲洗、负压引流后覆盖HTAS,可显著促进创面愈合,是一种有效的烧伤残余创面序贯性治疗方法.
Abstract
Objective To seek a sequential method for the management of residual wounds in burn patients. Methods Three chronic residual wounds on each of 25 burn patients were either covered with vaseline gauze (A group) , human tissue-engineered active skin ( ActivSkin, B group) or ActivSkin after rinsing with fluid containing oxygen and vacuum assisted drainage (C group) on wounds. The contents of (TNF)α in granulation tissue were assayed by enzyme linked immunosorbent assay (ELISA). Expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue was determined with reverse transcription poly-merase chain reaction (RT-PCR). Moreover, quantity of wound bacteria in the wounds and wound healing rate were determined with usual method. Results The quantities of wound bacteria in C group on 3,6,9, 12 post-treatment day(PTD) were (5. 30 ± 1. 60) , (1. 30 ±0. 80) , (1. 70 ±0. 60) and (0.60 ±0. 10) clone formation unit/ml( CFU/ml) , respectively, which were obviously lower than those in A and B groups. The contents of TNFα and expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue in C group on 6 PTD were [(0.650 ±0.040)ng/mg and 0.210 ±0.010] , respectively, and they were evidently lower than those in A group[ (1.550 ±0. 370) ng/mg, 1.040 ±0.050, P <0.0l] and B group (0.810 ±0.080) ng/mg, 0. 640 ±0.030, P <0.01]. Meanwhile, the contents of (TNF)α and expression of MMP-13 mRNA in B group were also obviously lower than those in A group. The wound healing ratio in C group on 15 and 30 PTD were markedly higher than those in A or B group ( P <0. 01). Conclusion Covering the residual burn wounds with ActivSkin after rinsing with fluid containing oxygen followed by vacuum assisted drainage can improve repairing of residual burn wounds.
关键词
烧伤/氧/皮肤/人工/组织工程/负压引流/序贯Key words
Burns/Oxygen/Skin,artificial/Tissue engineering/Vacuum-assisted closure/Sequential引用本文复制引用
出版年
2007
NETL
NSTL
维普
万方数据