VENOUS ULCERS
VENOUS ULCERS
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DOI：
10.1016/0002-9610(94)90009-4
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发表时间：
1994-01-01
影响因子：
3
通讯作者：
BURTON, CS
中科院分区：
文献类型：
--
作者：
BURTON, CS
静脉溃疡的成功治疗结合了局部伤口治疗方式和动态血流动力学支持，以控制潜在疾病。加压包扎减少或消除水肿，潮湿的伤口环境不仅清除坏死组织，而且有助于肉芽组织的发育，这是表皮修复的先决条件。我们使用水胶体敷料封闭了已知严重定植的慢性伤口长达7天，发现发生了软组织感染。在我们诊所所有敷料更换中仅占1%，而文献中通常报告的比例为6.5%。在静脉性溃疡中，常驻细菌可能是有益的，因为它们的蛋白水解活性有助于纤维蛋白脓性伤口渗出物的自溶。溶解纤维蛋白和减少现有纤维蛋白“袖”的数量，从而改善局部组织氧合和营养/废物交换的重要性尚不完全清楚;然而，这种现象可以部分解释一种水胶体敷料（DuoDERM）获得的优异临床结果，已证明其比其他类型的保湿和水胶体敷料更有效地溶解纤维蛋白。
Successful therapy of venous ulcers combines local wound treatment modalities and ambulatory hemodynamic support to control the underlying disease. Compression bandaging reduces or eliminates edema, and a moist wound environment not only debrides necrotic tissue but also aids development of granulation tissue, a prerequisite for epidermal repair. We have occluded chronic wounds, known to be heavily colonized, with a hydrocolloid dressing for up to 7 days and found that soft-tissue infections occurred. in only 1% of all dressing changes in our clinic, compared with 6.5% generally reported in the literature. In venous ulcers, resident bacteria may be beneficial in that their proteolytic activity assists with autolysis of fibrinopurulent wound exudate. The importance of lysing fibrin and reducing the number of existing fibrin ''cuffs,'' thereby improving local tissue oxygenation and nutrient/waste exchange, is not completely understood; however, this phenomenon, in part, may explain the excellent clinical results obtained with one type of hydrocolloid dressing (DuoDERM), which has been shown to lyse fibrin more effectively than other types of moisture-retentive and hydrocolloid dressings.