Department of Dermatology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Department of Dermatology, Self Defense Force Hanshin Hospital, Kawanishi, Hyogo, Japan.
Int Wound J. 2013 Oct;10(5):542-8. doi: 10.1111/j.1742-481X.2012.01016.x. Epub 2012 Jul 9.
Selecting an appropriate treatment for a given case of skin wound is crucial for inducing optimal healing. We used an animal model developed from normal rabbit ears in order to assess the efficacy of treatments for skin wounds with or without a wet dressing, anti microbial reagent or topical wound-stimulatory reagents. The degree of healing in each group was evaluated and compared using four histological parameters: (i) degree of reepithelialisation, (ii) amount of granulation tissue formation, and (iii) the number of capillary lumens and (iv) fibroblasts in the granulation tissue. Treatment using wet dressings resulted in an increase in capillary number compared with the open dry wound. Although the retention of povidone-iodine (PI) in wound tissue after application significantly inhibited reepithelialisation (P < 0.05), rinsing PI off with saline was comparable in effect to using only a wet dressing. The three topical reagents, namely, basic fibroblast growth factor, prostaglandin E1 and dibutyryl cyclic adenosine monophosphate, significantly improved reepithelialisation (P < 0.05). In conclusion, wounds should be kept hydrated by applying topical reagents. If there are any signs of bacterial infection, PI can be applied and rinsed later with saline in order to minimise its cytotoxic effects.
选择适当的治疗方法对皮肤伤口的治疗至关重要,这可以促进伤口的最佳愈合。我们使用从正常兔耳中建立的动物模型,来评估有无湿性敷料、抗菌试剂或局部刺激伤口试剂的情况下治疗皮肤伤口的疗效。使用四种组织学参数评估并比较每个组的愈合程度:(i)上皮再形成的程度,(ii)肉芽组织形成的量,(iii)肉芽组织中的毛细血管腔和(iv)成纤维细胞的数量。与开放干燥伤口相比,湿性敷料的应用可增加毛细血管数量。尽管在应用后聚维酮碘(PI)在伤口组织中的保留显著抑制上皮再形成(P < 0.05),但用生理盐水冲洗 PI 与仅使用湿性敷料的效果相当。三种局部试剂,即碱性成纤维细胞生长因子、前列腺素 E1 和二丁基环腺苷酸单磷酸,可显著改善上皮再形成(P < 0.05)。总之,应用局部试剂可保持伤口湿润。如果有任何细菌感染的迹象,可以应用 PI 并随后用生理盐水冲洗,以尽量减少其细胞毒性作用。