潮湿、湿润和干燥环境对伤口愈合及炎症的临床影响。

Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments.

作者信息

Junker Johan P E, Kamel Rami A, Caterson E J, Eriksson Elof

机构信息

Division of Plastic Surgery, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.

出版信息

Adv Wound Care (New Rochelle). 2013 Sep;2(7):348-356. doi: 10.1089/wound.2012.0412.

Abstract

SIGNIFICANCE

Successful treatment of wounds relies on precise control and continuous monitoring of the wound-healing process. Wet or moist treatment of wounds has been shown to promote re-epithelialization and result in reduced scar formation, as compared to treatment in a dry environment.

RECENT ADVANCES

By treating wounds in a controlled wet environment, delivery of antimicrobials, analgesics, other bioactive molecules such as growth factors, as well as cells and micrografts, is allowed. The addition of growth factors or transplantation of cells yields the possibility of creating a regenerative wound microenvironment that favors healing, as opposed to excessive scar formation.

CRITICAL ISSUES

Although several manufacturers have conceived products implementing the concept of moist wound healing, there remains a lack of commercial translation of wet wound-healing principles into clinically available products. This can only be mitigated by further research on the topic.

FUTURE DIRECTIONS

The strong evidence pointing to the favorable healing of wounds in a wet or moist environment compared to dry treatment will extend the clinical indications for this treatment. Further advances are required to elucidate by which means this microenvironment can be optimized to improve the healing outcome.

摘要

意义

伤口的成功治疗依赖于对伤口愈合过程的精确控制和持续监测。与在干燥环境中治疗相比,湿性或湿润性伤口治疗已被证明可促进上皮再形成并减少瘢痕形成。

最新进展

通过在可控的湿润环境中治疗伤口,可以实现抗菌剂、止痛剂、其他生物活性分子(如生长因子)以及细胞和微移植物的递送。添加生长因子或进行细胞移植有可能创造一个有利于愈合的再生伤口微环境,而不是过度形成瘢痕。

关键问题

尽管有几家制造商已构思出实施湿性伤口愈合概念的产品,但湿性伤口愈合原则在临床上仍缺乏商业化转化为可用产品。这只能通过对该主题的进一步研究来缓解。

未来方向

与干燥治疗相比,有力证据表明在湿性或湿润环境中伤口愈合良好,这将扩大这种治疗的临床适应症。需要进一步取得进展以阐明通过何种方式可以优化这种微环境以改善愈合效果。

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