Ger R
Department of Surgery, Nassau County Medical Center, East Meadow, NY, USA.
Ostomy Wound Manage. 1996 Oct;42(9):40-6.
An ideal result in wound healing is expedited closure with full-thickness skin, as opposed to thin, fragile epithelium prone to future breakdown. To help achieve accelerated healing by full thickness skin, a device has been designed that applies constant tension traction to the wound margins. The device acts by both approximating the wound and by encouraging tissue and skin generation through stimulating angiogenesis and epithelial proliferation. This study includes 31 patients with 36 wounds of varying etiologies treated over 28 days. The wounds were inspected every 3 to 5 days at which time the dressings were changed and new devices applied, as needed. All but five of the wounds healed completely with full thickness skin within the study period (average: 15 days; range: 7-28 days). The longest healing times occurred in the patients with pressure ulcers. Using a formula for determining healing time based on excisional wound dimension, the expected healing time of a 3cm wide foot ulcer with uninterrupted progress is 41 days. The time for such a wound to heal in this study was 21 days. The approximating device accelerated wound healing by full thickness skin for the wounds included in this study. Other considerations when using this method include cost, patient compliance and indications/contraindications.
伤口愈合的理想结果是通过全层皮肤实现快速闭合，而不是形成薄而脆弱、易于日后破溃的上皮。为了借助全层皮肤实现加速愈合，设计了一种装置，该装置可对伤口边缘施加恒定的张力牵引。该装置的作用方式包括使伤口靠拢，以及通过刺激血管生成和上皮增殖来促进组织和皮肤生成。本研究纳入了31例患者的36处不同病因的伤口，治疗时间为28天。每3至5天检查一次伤口，届时更换敷料，并根据需要应用新装置。除5处伤口外，其余所有伤口均在研究期间实现了全层皮肤完全愈合（平均：15天；范围：7 - 28天）。愈合时间最长的是压疮患者。根据切除伤口尺寸确定愈合时间的公式，一个3厘米宽的足部溃疡若不间断进展，预期愈合时间为41天。在本研究中，此类伤口的愈合时间为21天。本研究中所涉及的伤口，该靠拢装置通过全层皮肤加速了伤口愈合。使用此方法时的其他考虑因素包括成本、患者依从性以及适应证/禁忌证。
