Agren M S, Mertz P M, Franzén L
Department of Dermatology & Cutaneous Surgery, University of Miami School of Medicine, FL 33101, USA.
J Am Acad Dermatol. 1997 Jan;36(1):53-8. doi: 10.1016/s0190-9622(97)70325-6.
Little objective information is available on the influence of occlusive dressings on the healing of cutaneous full-thickness wounds.
Our purpose was to examine the effects of three occlusive dressings-two hydrocolloid dressings (Comfeel Ulcer Dressing, Coloplast A/S, Espergaerder, Denmark [hydrocolloid dressing A] and DuoDERM; ConvaTec, Princeton, N.J. [hydrocolloid dressing B]) and one polyurethane film dressing (OpSite, Smith & Nephew, Hull, U.K. [film dressing])-on tissue reactions, degree of inflammation, wound contraction, and epithelialization in full-thickness wounds in domestic pigs.
Standardized 20 mm full-thickness punch biopsy wounds were treated for 10 days. Healing was assessed by light microscopy and by planimetry.
Material from both hydrocolloid dressings was phagocytosed as indicated by the presence of foam cells in the granulation tissue. Granulomatous tissue reactions around extracellular vacuoles were found in 10 of 12 hydrocolloid dressing B-treated wounds compared with one in hydrocolloid dressing A-treated wounds and in none of the 10 film dressing-treated wounds (p < 0.0001). Inflammation was significantly (p < 0.002) more pronounced in hydrocolloid dressing B-treated wounds. The extracellular vacuoles in the hydrocolloid dressing B group contained dressing material as demonstrated by Fourier transform infrared microscopy. There was a tendency (p < 0.07) towards a delayed entry into the contraction phase with hydrocolloid dressing B, but there was no significant difference in epithelialization between the three dressings.
Wound tissue reactions to different hydrocolloid dressings vary depending on composition. The tissue reactions had no significant effect on wound contraction or epithelialization.
关于封闭性敷料对皮肤全层伤口愈合影响的客观信息较少。
我们的目的是研究三种封闭性敷料——两种水胶体敷料（康惠尔溃疡贴，康乐保公司，丹麦埃斯佩尔盖德 [水胶体敷料A] 和多爱肤；康维德公司，新泽西州普林斯顿 [水胶体敷料B]）以及一种聚氨酯薄膜敷料（优拓，施乐辉公司，英国赫尔 [薄膜敷料]）——对家猪全层伤口组织反应、炎症程度、伤口收缩和上皮形成的影响。
对标准化的20毫米全层打孔活检伤口进行10天的治疗。通过光学显微镜和面积测量法评估愈合情况。
如肉芽组织中存在泡沫细胞所示，两种水胶体敷料的材料均被吞噬。在12个接受水胶体敷料B治疗的伤口中，有10个伤口在细胞外液泡周围出现肉芽肿性组织反应，相比之下，接受水胶体敷料A治疗的伤口中有1个出现该反应，而10个接受薄膜敷料治疗的伤口中均未出现（p < 0.0001）。水胶体敷料B治疗的伤口炎症明显更显著（p < 0.002）。傅里叶变换红外显微镜显示，水胶体敷料B组的细胞外液泡中含有敷料材料。水胶体敷料B有延迟进入收缩期的趋势（p < 0.07），但三种敷料在上皮形成方面无显著差异。
伤口组织对不同水胶体敷料的反应因成分而异。组织反应对伤口收缩或上皮形成无显著影响。
