Development of antimicrobial agent-impregnated wound dressing and composite cultured skin : fundamental and clinical evaluations

新型创面敷料的发展：开发了多种类型的敷料，其中一些敷料已成功应用于烧伤和压疮的治疗。重要的是选择对每个伤口有最佳功能的伤口敷料。为了提供一种新的治疗方法，作者开发了一种新的伤口敷料，该敷料由磺胺嘧啶银（AgSD）浸渍的聚氨酯膜和吸水无纺布作为衬底的层压组成。AgSD为50马克杯/厘米^2的创面敷料能有效抑制细菌生长，防止外部细菌侵袭。这种伤口敷料也被发现在临床病例中是有用的。128例患者中，87%（26/30）的供体部位、97%（38/39）的烧伤、92%（11/12）的皮肤缺损、94%（33/35）的压疮和83%（10/12）的皮肤溃疡获得良好评价。新型体外培养皮肤替代物的研究进展：由角质细胞或成纤维细胞组成的同种异体体外培养皮肤替代物被认为是一种极好的促进伤口愈合的生物敷料。细胞跨越主要组织相容性屏障的成功应用表明，应用细胞的免疫原性很弱，无法在宏观上检测到排斥反应。此外，这些细胞还能释放一些生物活性物质，如细胞因子和生长因子。本研究旨在探讨异体培养真皮替代物（CDS）在临床病例中的疗效。同种异体CDS的制备方法是将成纤维细胞涂覆在海质胶原基质上，然后在添加10%胎牛血清的Dulbecco改良Eagle培养基中培养1周。在实践中，将CDS涂在创面上，在其上涂上一层覆盖材料，即上文所述的agsd浸渍创面敷料，以保护CDS。对烧伤、压疮、皮肤溃疡、皮肤缺损等60例进行评价。本初步临床研究表明，CDS与浸渍agsd的伤口敷料联合使用可有效促进肉芽组织形成和伴随的上皮化。少

Development of new wound dressing : Many types of would dressings have been developed, and some of them have been applied successfully in the treatment of burns and pressure sores. It is important to select the wound dressing which has an optimum function for each individula wound. To provide a new therapy, the authors have developed a new wound dressing composed of silver sulfadiazine (AgSD) -impregnated polyurethane membrane, laminated with a water absorbent non-woven fabric as a backing. The wound dressing with AgSD of 50 mug/cm^2 was found to be effective in suppressing bacterial growth and in preventing external bacterial invasion. This wound dressing was also found to be useful in clinical cases. Of 128 cases, 87% (26/30) of donor site, 97% (38/39) of burns, 92% (11/12) of skin defects, 94% (33/35) of pressure sore, and 83% (10/12) of skin ulcers were evaluated as achieving good result.Development of new cultured skin substitute : Allogeneic cultured skin substitute composed of k … More eratinocytes or fibroblasts has been considered to be an excellent biological dressing which can promote wound healing. The successful application of cells across major histocompatibility barriers suggests that applied cells is so weakly immunogeneic that a rejection can not be detected macroscopicaly. In addition, these cells can release some kinds of biologically active substances like cytokines and growth factors. The present study was designed to examine the efficacy of allogeneic cultured dermal substitute (CDS) in clinical cases. The allogeneic CDS was prepared by plating fibroblasts on a spongy collagen matrix, followed by culturing for 1 week in Dulbecco's modified Eagle's medium supplemented with 10% FBS.In practice, the CDS was applied on the wound surface, over which a covering material, AgSD-impregnated wound dressing described above, was applied to protect the CDS.The evaluation was conducted in 60 cases including burn, pressure sore, skin ulcer, and skin defect. This preliminary clinical study suggests that the application of CDS in conjunction with AgSD-impregnated wound dressing is effective in promoting granulation tissue formation and concomitant epithelialization. Less