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含热塑性聚氨酯的银纳米颗粒对糖尿病下肢开放性骨折患者术后康复的影响。

Effect of Silver Nanoparticles With Thermoplastic Polyurethane on Postoperative Rehabilitation of Diabetic Patients With Open Fracture of Lower Extremities.

作者信息

Zhang Dong, Yao Dongchen, Ma Ruofei, Nan Shaokui, Lv You, Zhu Yue, Zhu Shiwen

机构信息

Department of Orthopedic Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.

Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital (The Fourth Medical College of Peking University), Beijing, China.

出版信息

Front Surg. 2022 Jul 11;9:954155. doi: 10.3389/fsurg.2022.954155. eCollection 2022.

Abstract

OBJECTIVE

This retrospective study aims to explore the effect of silver nanoparticles with thermoplastic polyurethane (TPU/NS) on the rehabilitation of diabetic patients with open fracture of lower extremities.

METHODS

Diabetic patients ( = 98) with open fracture of lower extremities treated in our hospital were analyzed retrospectively from June 2015 to December 2021. TPU/NS nanocomposites were prepared for postoperative treatment of diabetic patients with open fracture of lower extremities. First, the cultured and were used to test the antibacterial effect of TPU/NS dressing . After using TPU/NS dressing (observation group) and traditional dressing (control group), the inflammatory reaction, clinical treatment, functional rehabilitation, and adverse reactions in patients were compared.

RESULTS

TPU/NS dressing effectively inhibited the growth of bacteria with a minimum inhibitory concentration of 2 μg/mL. The usage of TPU/NS dressing reduced the inflammatory reaction by reducing positive rate of bacteria after the dressing on the seventh day postoperatively. Besides, the times of dressing, stopping time of wound exudation, wound healing time, length of hospital stay, and VAS score in the observation group were lower than those in the control group; the incidence of adverse reactions after treatment was lower in the observation group as compared with the control group (17.07% vs. 35.09%). Meanwhile, the functional rehabilitation and life quality of patients in the observation group were better TPU/NS dressing treatment.

CONCLUSION

TPU/NS dressing has the function of promoting the postoperative recovery of patients by inhibiting the bacterial infection of the wound, thus improving the limb function and life quality. As a result, there was a tremendous potential to apply the constructed TPU/NS membrane to diabetic patients with open fractures, especially those with soft tissue injury.

摘要

目的

本回顾性研究旨在探讨热塑性聚氨酯银纳米颗粒(TPU/NS)对糖尿病下肢开放性骨折患者康复的影响。

方法

回顾性分析2015年6月至2021年12月在我院治疗的98例糖尿病下肢开放性骨折患者。制备TPU/NS纳米复合材料用于糖尿病下肢开放性骨折患者的术后治疗。首先,用培养的……和……来测试TPU/NS敷料的抗菌效果。使用TPU/NS敷料(观察组)和传统敷料(对照组)后,比较患者的炎症反应、临床治疗、功能康复及不良反应。

结果

TPU/NS敷料能有效抑制细菌生长,最低抑菌浓度为2μg/mL。使用TPU/NS敷料可通过降低术后第7天敷料上细菌阳性率来减轻炎症反应。此外,观察组的换药次数、伤口渗液停止时间、伤口愈合时间、住院时间及视觉模拟评分(VAS)均低于对照组;观察组治疗后不良反应发生率低于对照组(17.07%对35.09%)。同时,观察组患者经TPU/NS敷料治疗后功能康复及生活质量更佳。

结论

TPU/NS敷料具有通过抑制伤口细菌感染促进患者术后恢复的作用,从而改善肢体功能和生活质量。因此,构建的TPU/NS膜在糖尿病开放性骨折患者,尤其是伴有软组织损伤的患者中应用潜力巨大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b032/9309470/e8a1bc392798/fsurg-09-954155-g001.jpg

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