Attinger Christopher E, Janis Jeffrey E, Steinberg John, Schwartz Jaime, Al-Attar Ali, Couch Kara
Georgetown Limb Center, Georgetown University Medical Center, Washington, DC 20007, USA.
Plast Reconstr Surg. 2006 Jun;117(7 Suppl):72S-109S. doi: 10.1097/01.prs.0000225470.42514.8f.
This is a clinical review of current techniques in wound bed preparation found to be effective in assisting the wound-healing process. The process begins with the identification of a correct diagnosis of the wound's etiology and continues with optimizing the patient's medical condition, including blood flow to the wound site. Débridement as the basis of most wound-healing strategies is then emphasized. Various débridement techniques, including surgery, topical agents, and biosurgery, are thoroughly discussed and illustrated. Wound dressings, including the use of negative pressure wound therapy, are then reviewed. To properly determine the timing of advance therapeutic intervention, the wound-healing progress needs to be monitored carefully with weekly measurements. A reduction in wound area of 10 to 15 percent per week represents normal healing and does not mandate a change in the current wound-healing strategy. However, if this level of wound area reduction is not met consistently on a weekly basis, then alternative healing interventions should be considered. There is a growing body of evidence that can provide guidance on the appropriate use of such adjuvants in the problem wound. Several adjuvants are discussed, including growth factor, bioengineered tissues, and hyperbaric medicine.
这是一篇关于伤口床准备当前技术的临床综述，这些技术被发现对辅助伤口愈合过程有效。该过程始于对伤口病因的正确诊断，接着是优化患者的身体状况，包括伤口部位的血流。然后强调清创术是大多数伤口愈合策略的基础。对各种清创技术，包括手术、外用制剂和生物手术进行了全面讨论和说明。接着回顾了伤口敷料，包括负压伤口治疗的使用。为了正确确定提前进行治疗干预的时机，需要每周进行测量以仔细监测伤口愈合进程。伤口面积每周减少10%至15%代表正常愈合，无需改变当前的伤口愈合策略。然而，如果每周伤口面积减少未持续达到这一水平，则应考虑其他愈合干预措施。越来越多的证据可为在疑难伤口中适当使用此类佐剂提供指导。讨论了几种佐剂，包括生长因子、生物工程组织和高压氧治疗。
