Zhang Guo-an
Department of Burns, Jishuitan Hospital, Beijing 100035, P.R. China.
Zhonghua Shao Shang Za Zhi. 2008 Oct;24(5):346-8.
For burn patients, topical treatment is as important as systemic treatment. Reasonable and timely wound treatment will influence the homeostatic equilibrium, and the progression, the prognosis, and the outcome of the disease. The therapeutic principle should be varied for wounds with different depth of injury. But avoiding or at least alleviating infection, and accelerating healing period, were the common principles. In common, the medication for local wound treatment includes: topical antiseptic, surgical dressing products, artificial skins, and so on. Ideal topical antiseptic should have the following characteristics: the antimicrobial spectrum is broad, including Pseudomonas aeruginosa and MRSA; be able to penetrate necrotic tissue; does not induce drug resistance easily; no local irritating effect and not painful; no side effect to body;can be applied easily; low cost. The functions of surgical dressing include: protect the wounds, keep the microcirculation open, and accelerate wound healing. Artificial skin has been used as the autoskin carrier in skin transplantation operation for large burn area to protect the autoskin grafts, accelerate wound healing, and cover the wounds temporarily. Burns therapy has developed for 50 years in China, the study of local treatment for burn wounds has also experienced a tortuous path of trial and error. This review might contribute some ideas future research.
对于烧伤患者,局部治疗与全身治疗同样重要。合理及时的创面处理会影响体内稳态平衡以及疾病的进展、预后和转归。对于不同深度损伤的创面,治疗原则应有所不同。但避免或至少减轻感染以及加速愈合期是共同的原则。一般来说,局部创面治疗的用药包括:外用抗菌剂、手术敷料产品、人工皮肤等。理想的外用抗菌剂应具备以下特点:抗菌谱广,包括铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌;能够穿透坏死组织;不易诱导耐药性;无局部刺激作用且无疼痛;对身体无副作用;易于应用;成本低。手术敷料的作用包括:保护创面、保持微循环通畅以及加速创面愈合。人工皮肤已被用作大面积烧伤皮肤移植手术中的自体皮载体,以保护自体皮移植片、加速创面愈合并临时覆盖创面。我国烧伤治疗已发展了50年,烧伤创面局部治疗的研究也经历了一条曲折的反复试验之路。本综述可能会为未来的研究提供一些思路。