De Coninck A, Draye J P, Van Strubarq A, Vanpée E, Kaufman L, Delaey B, Verbeken G, Roseeuw D
Department of Dermatology, Vrije Universiteit Brussel, Belgium.
J Dermatol Sci. 1996 Dec;13(3):202-11. doi: 10.1016/s0923-1811(96)00536-1.
This study, based upon a pig model, was conducted to investigate the effects of moist and dry healing conditions on wound closure (epithelialization, granulation tissue, contraction) of full-thickness wounds. Thirty-two full-thickness square wounds (3 cm x 3 cm) covered with either an occlusive polyurethane dressing (Tegaderm) or a non-occlusive dressing (Melolin) were evaluated. The effect of the presence or the absence of a gel (3% Idroramnosan) was also investigated with both dressings. The dressings were renewed twice a week. The time required for wound closure was 19.2 +/- 1.6 days for Tegaderm and 26.6 +/- 3.0 days (means +/- SD) for Melolin, respectively. The healing time of the full-thickness porcine wounds was significantly (P < 0.001) reduced by the occlusive dressing. Equivalent results were found with the 3% gel, indicating that the gel can be used as a neutral vehicle. The healing rate, calculated according to Gilman's method, was also significantly (P < 0.001) enhanced by the occlusive dressing. This progression was 0.073 +/- 0.004 cm/day and 0.050 +/- 0.009 cm/day (means +/- SD) for Tegaderm and Melolin, respectively. The contribution of contraction to wound closure was similar in all wounds, indicating that the occlusive dressing did not have an effect on wound contraction. Histological evaluation was performed on full-thickness skin biopsies of whole wound harvested from the time of wound closure to 3 months after. At any time point, no significant histological variations were observed between the different treated wounds. This study demonstrates in a porcine model that for full-thickness wounds, as for split-thickness wounds, occlusive dressing enhances healing rate and shortens the time for wound repair. The shortened healing time is a function primarily of the effect of occlusive dressing on epithelialization, especially the third phase of wound resurfacing.
本研究基于猪模型,旨在探讨湿润和干燥愈合条件对全层伤口愈合(上皮化、肉芽组织、收缩)的影响。评估了32个全层方形伤口(3厘米×3厘米),这些伤口分别覆盖有封闭性聚氨酯敷料(德湿可)或非封闭性敷料(美罗宁)。同时还研究了两种敷料添加或不添加凝胶(3%依多聚甘露糖醛酸)的效果。敷料每周更换两次。德湿可组伤口愈合所需时间为19.2±1.6天,美罗宁组为26.6±3.0天(均值±标准差)。封闭性敷料显著缩短了猪全层伤口的愈合时间(P<0.001)。3%凝胶组也得到了类似结果,表明该凝胶可作为中性载体。根据吉尔曼方法计算的愈合率,封闭性敷料也使其显著提高(P<0.001)。德湿可组和美罗宁组的愈合进展分别为0.073±0.004厘米/天和0.050±0.009厘米/天(均值±标准差)。所有伤口中收缩对伤口愈合的贡献相似,表明封闭性敷料对伤口收缩没有影响。对从伤口愈合时到愈合后3个月采集的全层皮肤活检组织进行了组织学评估。在任何时间点,不同处理伤口之间均未观察到明显的组织学差异。本研究在猪模型中证明,对于全层伤口,如同对于断层伤口一样,封闭性敷料可提高愈合率并缩短伤口修复时间。愈合时间缩短主要是封闭性敷料对上皮化的作用,尤其是伤口再上皮化的第三阶段。