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慢性伤口的治疗趋势

Trends in the Treatment of Chronic Wounds.

作者信息

Sharma Rohit, Hruska Jan, Peter Lukas, Randlova Kristina, Kuca Kamil

机构信息

Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.

Betthera s.r.o., Hradec Kralove, Czech Republic.

出版信息

Curr Med Chem. 2024 Sep 13. doi: 10.2174/0109298673312649240829103906.

Abstract

Chronic wounds remain one of the significant burdens to health across the world, mainly in view of diabetes and its natural consequences. This category of lesions includes pressure ulcers, vascular diseases, and surgery-related wounds, which affect millions and pose a major challenge to the healthcare industry. The paper reviews the various physiological mechanisms of wound healing, factors that impede it, and some new treatments emerging at this moment. In contrast, current developments include surgical and non-surgical alternatives like topical dressings, medicated formulations, and skin substitutes. Advanced wound care today covers tissue-engineered skin substitutes, 3D-printed wound dressings, topical medicated formulations, and growth factor-based therapies. These are non-invasive, biocompatible methods that are cost-effective, userfriendly, and more conducive to natural healing than traditional therapies. Hydrogel dressings have high water content to create a moist environment that encourages healing. They also reflect excellent physicochemical and biological properties, which enhance autolytic debridement and reduction of pain due to the moisture retention, biocompatibility, and non-toxicity conferred. Tissue-engineered skin substitutes, comprising allogeneic or autologous cells, wound-healing enhancement bioengineered allogeneic cellular therapies are like the natural skin and encourage regeneration. 3D printing allows the production of customized dressings to aid in better treatment. Newer therapies, including bioengineered allogeneic cellular therapies and fish skin grafting, require more clinical trials to confirm safety and efficacy. With such innovations in wound healing technologies and therapies, the future looks quite promising in managing chronic wounds, enhancing healing, reducing healthcare expenditure, and promoting a better quality of life for patients.

摘要

慢性伤口仍然是全球健康的重大负担之一,主要是考虑到糖尿病及其自然后果。这类伤口包括压疮、血管疾病和手术相关伤口,影响着数百万人,给医疗行业带来了重大挑战。本文综述了伤口愈合的各种生理机制、阻碍伤口愈合的因素以及目前出现的一些新治疗方法。相比之下,目前的进展包括手术和非手术替代方法,如局部敷料、药物制剂和皮肤替代品。如今的先进伤口护理涵盖组织工程皮肤替代品、3D打印伤口敷料、局部药物制剂和基于生长因子的疗法。这些都是非侵入性、生物相容性好的方法,具有成本效益、用户友好,并且比传统疗法更有利于自然愈合。水凝胶敷料含水量高,可营造促进愈合的湿润环境。它们还具有出色的物理化学和生物学特性,由于其具有保水性、生物相容性和无毒性,可增强自溶性清创并减轻疼痛。组织工程皮肤替代品由同种异体或自体细胞组成,生物工程同种异体细胞疗法可促进伤口愈合,类似于天然皮肤并促进再生。3D打印可生产定制敷料,有助于更好地治疗。包括生物工程同种异体细胞疗法和鱼皮移植在内的新疗法需要更多临床试验来确认安全性和有效性。随着伤口愈合技术和疗法的这些创新,在管理慢性伤口、促进愈合、减少医疗支出以及提高患者生活质量方面,未来前景十分广阔。

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