Hess Christopher L, Howard Michael A, Attinger Christopher E
Georgetown University Hospital, Division of Plastic Surgery, Washington, DC, USA.
Ann Plast Surg. 2003 Aug;51(2):210-8. doi: 10.1097/01.SAP.0000058513.10033.6B.
Chronic or non-healing wounds may develop in the setting of many diseases and are the source of considerable morbidity as well as health costs. These wounds demand an aggressive, multifactorial approach including surgical debridement, revascularization, antibiotics and dressings. In addition several adjuvant treatment methods have been developed to further stimulate healing. Whirlpool, although used frequently, has not been proven to be of benefit. However, pulsed lavage does show a promising future. Ultrasound has demonstrated beneficial effects but further controlled studies are needed. Subatmospheric pressure therapy is associated with few complications and is fast becoming a mainstay of adjuvant therapy. Hyperbaric oxygen therapy has been shown to be effective for many types of wounds. Unfortunately, cost and access to chambers may prohibit its use on a routine basis. Finally, electrostimulation may be one of the up and coming therapies for the future. Though, more studies are needed to determine the mode of delivery for various types of wounds.
慢性或难愈合伤口可能在多种疾病背景下出现，是相当大的发病原因及医疗费用的来源。这些伤口需要积极的多因素治疗方法，包括手术清创、血管再通、抗生素和敷料。此外，还开发了几种辅助治疗方法以进一步促进愈合。漩涡浴虽然经常使用，但尚未被证明有益。然而，脉冲冲洗确实显示出有前景的未来。超声波已显示出有益效果，但还需要进一步的对照研究。负压疗法并发症少，正迅速成为辅助治疗的主要手段。高压氧疗法已被证明对多种类型的伤口有效。不幸的是，成本和舱室的使用可能会限制其常规使用。最后，电刺激可能是未来新兴的治疗方法之一。不过，需要更多研究来确定针对各种类型伤口的给药方式。
