Intractable wounds and infections: the role of impaired vascularity and advanced surgical methods for treatment
Intractable wounds and infections: the role of impaired vascularity and advanced surgical methods for treatment
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DOI：
10.1016/s0002-9610(03)00304-0
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发表时间：
2004-05-01
影响因子：
3
通讯作者：
Rinker, BD
中科院分区：
文献类型：
--
作者：
Hausman, MR;Rinker, BD
骨折不愈合、延迟愈合和骨髓炎仍然是严重的问题，具有很高的发病率和死亡率。愈合促进剂，包括骨形态发生蛋白、成纤维细胞生长因子和转化生长因子- β，在实验模型中调节骨生长，例如那些采用“临界间隙”建立骨不连的模型，但在临床情况下并不有效。这种矛盾可能与这样一个事实有关，即这些药物靶向细胞，然而在临床骨不连或骨髓炎的情况下，受影响的区域经常是低血管，因此缺乏目标前体细胞。伤口愈合依赖于局部组织的血管状况。外科手术，如局部和远程组织移植，旨在改变这种细胞缺乏，血管化不良的环境，已被证明是非常成功的，但往往是复杂和昂贵的。目前还没有简单的药理学方法来上调这种血管生成。(C) 2004年摘录医药股份有限公司版权所有。
Fracture nonunion, delayed union, and osteomyelitis remain serious problems with substantial morbidity and mortality rates. Healing promoters, including bone morphogenic proteins, fibroblast growth factors, and transforming growth factor-beta, regulate bone growth in experimental models, such as those employing a "critical gap" to establish nonunion, but have not been effective in clinical situations. This paradox may relate to the fact that such agents target cells, yet in the setting of a clinical nonunion or osteomyelitis, the affected area is frequently hypovascular and therefore deficient in target precursor cells. Wound healing is dependent on local tissue vascularity. Surgical procedures, such as local and remote tissue transfer, which are designed to modify this cell-deficient, poorly vascularized environment, have proved very successful but are often complex and costly. No simple pharmacologic means of upregulating such angiogenesis currently exists. (C) 2004 Excerpta Medica, Inc. All rights reserved.