OXYGEN IN THE CLINICAL MANAGEMENT OF WOUNDS

过去25年的研究在这个中心赠款已经巩固了 观察1）在缺氧条件下，许多伤口过程， 愈合不能正常进行，特别是抵抗感染， 胶原蛋白合成，血管生成和炎症; 2）这些 事实上，在超生理氧气下， 浓度;和3）缺氧条件是受伤的正常情况 组织和创伤患者。 这些观察结果不可避免地导致 结论是，照顾儿童的最关键方面之一是， 创伤患者是维持氧气输送到受伤 组织中 这需要在高PO 2下的高血流量， 必须有高的氧含量。 医生估计的外周 灌注通常不准确（通常高估）;因此， 除非测量组织氧，否则无法实现目标。 的目的 目前的建议是将组织血氧测定法从研究工具转变为 临床监测，通过识别手段消除障碍， 灌注，并通过证明使用这些手段结合PO 2 ICU环境中的监测导致改善的患者结果。

The past 25 years of research under this Center grant have solidified the observations 1) that under hypoxic conditions, many processes of wound healing cannot proceed normally, particularly resistance to infection, collagen synthesis, angiogenesis, and inflammation; 2) that these processes, in fact, work more efficiently at supraphysiologic oxygen concentrations; and 3) that hypoxic conditions are the norm in injured tissue and in trauma patients. These observations lead inescapably to the conclusion that one of the most critical aspects of the care of traumatized patients is maintenance of oxygen delivery to injured tissues. This requires high flow of blood at high PO2 but not necessarily high oxygen content. Physician estimates of peripheral perfusion are usually inaccurate (usually overestimates); therefore, this goal cannot be achieved unless tissue oxygen is measured. The aim of the current proposal is to convert tissue oximetry from a research tool to a clinical monitor, by identifying means to remove obstacles to perfusion, and by demonstrating that use of these means combined with PO2 monitoring in the ICU setting leads to improved patient outcome.