Yamamoto Naoto, Kiyosawa Tomoharu
Department of Plastic Surgery, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan.
Int Wound J. 2014 Dec;11(6):616-21. doi: 10.1111/iwj.12016. Epub 2012 Dec 21.
Occlusive dressing is widely accepted and used to manage skin ulcers. However, with respect to its application to incisional wounds, most studies have been conducted about the clinical effects on incisional healing of surgical sites. Studies of the histological effects of occlusive dressing for incisional wounds have been few. The aim of this study was to clarify the histological effects of occlusive dressings on healing of incisional skin wounds. Rat dorsal skin was incised down to the panniculus and sutured immediately. Dressing types included 2-octyl cyanoacrylate and hydrocolloid materials as occlusive dressings and no-dressing as the open therapy. Histological examination and dermoscopic observation were performed 1, 2, 4 and 7 days after surgery. The findings from each dressing type were compared. In the open therapy group, the upper portion of the edge of incision was necrosed minimally and finally healed with wide scar formation. However, in the occlusive dressing groups, micronecrosis of the incision edge seen in the no-dressing group was not observed, healing was more rapid and the remaining scar was finer. Occlusive dressing can prevent micronecrosis of the incision edge, resulting in rapid and excellent healing. This study shows that the efficacy of and supports the use of occlusive dressing in incisional wound management.
封闭敷料被广泛接受并用于处理皮肤溃疡。然而,关于其在切口伤口上的应用,大多数研究是针对手术部位切口愈合的临床效果进行的。关于封闭敷料对切口伤口组织学影响的研究较少。本研究的目的是阐明封闭敷料对切口皮肤伤口愈合的组织学影响。将大鼠背部皮肤切开至皮下组织并立即缝合。敷料类型包括作为封闭敷料的2-氰基丙烯酸辛酯和水胶体材料,以及作为开放疗法的不使用敷料。在术后1、2、4和7天进行组织学检查和皮肤镜观察。比较每种敷料类型的结果。在开放疗法组中,切口边缘上部的坏死程度最小,最终以广泛瘢痕形成而愈合。然而,在封闭敷料组中,未观察到不使用敷料组中出现的切口边缘微坏死,愈合更快,残留瘢痕更细。封闭敷料可防止切口边缘微坏死,从而实现快速且良好的愈合。本研究表明了封闭敷料在切口伤口处理中的有效性并支持其使用。