Abstract To observe the effect of fibroblast growth factor (FGF) on wound healing, 50 mice were divided into 5 groups. On the back of every mouse, 2 wounds were made by operative cuts, one for experiment and the other for control. The wounds of the experimental group were covered with 0.5ml FGF solution (contented FGF 300 μg/ml, heparin 100 μg/ml), whereas the wounds of the control group were covered with 0.5ml 0.9% NaCl solution. All of the wounds were dressed by sterilized gauze, and received the same treatment once a day. After 1,3,5,7,10 days, the mice in every group were sacrificed and the tissues of the wounds were collected and prepared for microscopic examination. The results showed that the capillaries and fibroblasts in the experimental group were markedly increased and reached the peak 2～3 days earlier than those in the control group. It was suggested that FGF promoted the formation of granulation tissue and the wound healing.
OBJECTIVE: To explore the molecular mechanisms involved in the increased collagen synthesis by platelet-derived wound healing factors (PDWHF) during wound healing in alloxan-induced diabetic rats. METHODS: Thirty-three male SD rats were divided into two groups, the normal (n = 9) (group A) and the diabetic group (n = 24). Two pieces of full-thickness skin with diameter of 1.8 cm were removed from the dorsal site of diabetic rats. PDWHF (100 micrograms/wound) was topically applied to one side of the diabetic wounds (group B) on the operation day and then once a day in the next successive 6 days. Meanwhile, bovine serum albumin (100 micrograms/wound) was applied to the other side of diabetic wound as control group (group C) in the same way. Levels of transforming growth factor-beta 1 (TGF-beta 1) and procollagen I mRNA in wound tissue were inspected by dot blotting. RESULTS: TGF-beta 1 mRNA levels in group B were 4 folds and 5.6 folds compared with those in group C after 5 and 7 days (P lt; 0.01), however, still significantly lower than those of group A (P lt; 0.05). There was no significance difference among three groups on the 10th day after wounding. The levels for procollagen I mRNA in group B amounted to 2.1, 1.8 and 2.3 folds of those in group C after 5, 7, and 10 days (P lt; 0.01), respectively. Compared with those in the group A, procollagen I mRNA levels in the group B were significantly lower after 5 and 7 days (P lt; 0.05), and no significant difference was observed between group B and A after 10 days. CONCLUSION: One important way for PDWHF to enhance the collagen synthesis in diabetic wound healing is to increase the gene expression of endogenous TGF-beta 1.
ObjectiveTo evaluate the effectiveness of liquid wound dressing in the treatment of chronic ulcer wounds. MethodsBetween January 2014 and October 2015, 84 patients with chronic ulcer wounds were included and divided into 2 groups randomly. The chronic ulcer wounds were covered with liquid wound dressing in the treatment group (n=44) and were managed with iodophor in the control group (n=40). There was no significant difference in age, gender, causes, location, wound area, and disease duration between 2 groups (P > 0.05). The frequency of dress changing, effective rate of treatment, wound healing time, wound healing rate at 5, 10, and 20 days, positive rate of bacteria culture at 1, 5, and 10 days, and the rate of side effect were recorded and compared between 2 groups. Vancouver scar scale was used to evaluate scar formation. ResultsThe effective rate of the treatment group (100%) was significantly higher than that of the control group (85%) (P=0.009). The frequency of dress changing in the treatment group[(11.36±3.40) times] was significantly lower than that in the control group[(16.94±4.51) times] (t=-6.231, P=0.000). The wound healing rates at 5, 10, and 20 days were significantly increased (P < 0.05) and the wound healing time was significantly decreased (t=-6.627, P=0.000) in the treatment group when compared with the control group. The positive rates of bacteria culture at 5 and 10 days in the treatment group were significantly lower than those in the control group (χ2=12.313, P=0.000; P=0.005), but no significant difference was found at 1 day (χ2=0.066, P=0.797). Side effect was observed in 4 cases of the control group. Vancouver scar scale score was 8.59±1.32 in the treatment group and was 9.85±1.65 in the control group, showing significant difference (t=-3.752, P=0.000). ConclusionThe application of the liquid wound dressing in the treatment of chronic ulcer wound can improve the wound healing rate, shorten the healing time and decrease the frequency of dress change, which could promote the wound healing process.
Tracheotomy is a commonly used measure in clinical rescue of critically ill patients, and it has an important impact on the survival outcome of patients. The time of extubation directly affects the recovery process of the patient. This article reviews the research progress of extubation management of tracheotomy patients at home and abroad, and mainly summarizes and elaborates from four aspects, including the role of the multidisciplinary team in tracheostomy management, where tracheostomy patients are extubated, conditions for extubation in tracheotomy patients, and wound care after extubation in tracheotomy patients. The purpose is to provide a reference for the selection of extubation timing and extubation management for patients with tracheotomy, to improve the success rate of extubation and improve the quality of life of patients.
Objective To compare the clinical effect between alginate calcium dressing and radix yarn dressing after anal fistula surgery. Methods A survey of 128 patients with anal fistula from April to October 2008 were studied. Patients were divided into two groups using a simple random method: 64 cases in therapy group which were treated with alginate calcium dressing and 64 cases in control group which were treated with traditional radix yarn dressing. The difference of the wound recovery indexes between two groups was compared.Results With regard to age, gender, anal fistula type, the proportion of preoperative diabetes and the diameter of wound, there was no statistical significance between therapy group and control group (Pgt;0.05). The proportion of slight pain during dressing change in therapy group (45.32%, 29/64) was more than control group (25.00%, 16/64), which had statistical significance (Pgt;0.05). The incidence of skin allergy was significantly different between two groups (29.69% vs. 60.94%, P＜0.05). Also, the rotten tissue and the soakage disappears with a shorter period, which both had statistical significance 〔(8.60±2.37) d vs. (12.22±3.29) d， (16.96±5.83) d vs. (22.02±5.90) d〕， Plt;0.05.Conclusion With the shorten of inflammatory and increment stage of the wound recovery, alginate calcium dressing is an ideal material for the postoperative duration of surgery of anal fistula.
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.
ObjectiveTo investigate multidisciplinary collaborative role in the treatment of patients with lower extremity degloving injury. MethodsThe wound therapy group and the Department of Orthopedics, Nutrition, and Psychology, and the Pain Clinic and Rehabilitation team collaboratively carried out the comprehensive intervention for a patient with lower extremity degloving injury in March 2013 in our hospital. The wound therapist was responsible for correct evaluation, debridement, infection control, maintaining moisture balance, and protecting wound edges of the skin; The wound team members were responsible for the entire treatment and healing process in the form of text and photos; Department of Orthopedics was responsible for secondary skin graft; Nutrition division was responsible for the correction of anemia in patients with hypoalbuminemia; Psychological service was responsible for psychological counseling as treatment accident sometimes brought psychological trauma; Pain outpatient service was responsible for consultation, formulating specific plans to control and relieve the patient's pain, and promote the patient's physical and mental rehabilitation process; Rehabilitation division was responsible for the guidance of patients on lower limb function exercise, prevention of knee joint rigidity, muscle stiffness, to promote the functional recovery of lower limbs. ResultsThe patient's wound was healed completely without scar or joint contracture. Function of lower limbs recovered to normal. Patients was very satisfied to the treatment, and had a total full recovery of body and mind, and returned to the family and society. ConclusionMultidisciplinary collaboration treatment for patients with lower extremity degloving injury can ease pain, eliminate psychological barriers, promote wound healing, and maintain the limb function.