负压封闭引流术在糖尿病足中的应用现状

朱世琴1 邓波2 李飞2  综述  李显蓉3  审校

1.西南医科大学附属医院内分泌科，四川泸州646000；2.西南医科大学护理学院，四川泸州646000  3. 西南医科大学附属医院胃肠外科，四川 泸州 646000

[摘要]糖尿病足是临床慢性伤口治疗的主要难题之一。负压封闭引流技术作为创面修复领域的一项新技术，目前已被广泛应用于糖尿病足的治疗，并已取得一定的成效。本文将对负压封闭引流技术在糖尿病足治疗及护理中的应用进行相关综述，为罹患糖尿病足的慢性病患者提供一种安全有效的创面修复治疗技术。

[关键词]糖尿病足；封闭负压引流术；护理

[中图分类号]R587.1 [文献标志码] A 10.3969/j.issn.1672-3511.2019.11.033

Application status of vacuum sealing drainage in diabetic foot

ZHU Shiqin1， DENG Bo2， LI Fei2  reviewing  LI Xianrong3 chenking.

[Abstract] Diabetic foot is one of the major problems in clinical chronic wound treatment and it is also an important public health problem. Vacuum sealing drainage technology, as a new technique in the field of wound repair, has been widely used in the treatment of diabetic foot and has achieved certain results. This paper reviews the application of negative pressure sealing drainage technique in treating diabetic foot and nursing care, so as to help clinical nurses grasp accurately the current situation of negative pressure sealing drainage. Thus providing a safe and effective treatment technique for wound healing for patients with chronic diseases suffering from diabetic foot.
[keywords] Diabetic foot ulcers; Vacuum sealing drainage; Nursing

表皮干细胞活性复合皮肤修复 裸鼠全层皮肤缺损

胡葵葵 戴育成 李剑 袁敬东 李洁 吴琼

【摘要】 目的用表皮干细胞和成纤维细胞作为种子细胞，研制一种增殖能力强具有表皮、真皮的组织工程化人工复合皮肤。方法从幼儿包皮中分离表皮干细胞，用胶原Ⅳ纯化、富集表皮干细胞，接种在3T3细胞滋养层上．将体外传代培养的表皮干细胞和真皮成纤维细胞分别接种在经冷冻干燥及戊二醛交联的J．型胶原基质网架的两侧，在液面下培养2周后，改为气一液界面培养，构建复合皮肤，移植到裸鼠全层皮肤缺损处，以表皮细胞胶原海绵复合皮肤和无细胞接种的胶原海绵膜作为对照。术后进行大体观察，在第7、14、21天取材行组织学、免疫组织化学及电镜观察。结果用表皮干细胞构建的复合人工皮肤增殖能力强．新生的皮肤瘢痕轻，形态满意，创面愈合的速度和质量均优于对照组。结论在胶原海绵上用表皮干细胞构建的复合人工皮肤增殖能力强，较好地解决了种子细胞的老化问题，可望成为一种较为理想的皮肤替代物。

【关键词】 表皮干细胞； 复合人工皮肤； 创面愈合； 组织工程

Repair of fu¨skin Ioss with composite graft of epidermal stem cells in nude mice HU Kui-kui，DAI Yu一cheng，Li Jian ，YUAN Jing—dong，Li Jie，WU Qiong．Center of Plastic，laser and  Cosmetic surger一y，Second Affiliated Hospital, Jiangxi Medical Collage , Nanchang   330006，China

【Abstract】

Objective: To constitute a composite skin substitute that can proliferate well with epidermal stem cells and fibroblasts on collagen sponge．

Methods:  Epidermal stem cells were selected by rapid attachment to c01lagenⅣfor 10～15 min and cultured on 3T3 feeder layer． Collagen was extracted from rat tail_ The matrix lattice was fabricated by a freeze—dryer and cross—linked with glutaraldehyde． Fibroblasts (1 x 106／cm2) were inoculated on collagen sponge and cultured for 2 weeks prior to inoculation of epidermal stem cells(2×105／cm2) to construct composite skin substitute．The artificial skin was grafted onto full skin 10ss wounds of nude mice．Collagen sponge membrane lacking cell inoculation and a composite skin substitute with keratinocytes and fibroblasts were used as controls． The wounds were observed daily． Tj\issue samples were harvested and examined by means of histology，immunohistochemistry and electron microcopy．

Results：Composite graft with epidermal stem cells proliferated promptly，and achieved a good adherence to wound on the 3rd day of grafting．the mice exhibited less epidermal scar formation and satisfactory contour of the skin．The quality and speed of wound healing in experimental groups were superior to those in the control groups．

Conclusion: Composite graft with epidermal stem cells have potential prospects in application of repairing skin defect with advantage of good proliferation．

【Key words】Epidermal stem cell；Compound artificial skin；Wound healing；Tissue engineerlng

Evaluation of healing outcomes combining a novel polymer formulation with autologous skin cell suspension to treat deep partial and full thickness wounds in a porcine model: a pilot study

Bonnie C. Carneya,b,h , Mary A. Oliverb , Metecan Erdi c , Liam D. Kirkpatrickb , Stephen P. Tranchinab , Selim Rozyyevd , John W. Keylounb,e , Michele S. Saruwatarid,e , John L. Daristotlef , Lauren T. Moffatta,b,h , Peter Kofinasc , Anthony D. Sandlerd , Jeffrey W. Shuppa,b,g,h,⁎

a Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center,Washington, DC, USA

b Firefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA

c Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, MD 20742, USA

d Sheikh Zayed Institute for Pediatric Surgical Innovation, Joseph E. Robert Jr. Center for Surgical Care, Children’s National Medical Center, Washington, DC 20010, USA

e Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC, USA

f David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA

g The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA h Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA

article info

Keywords: Autologous skin cell suspension   Solution-blow spinning polymer   Wound dressings   Hypertrophic scarring  Skin grafting

abstract

      Autologous skin cell suspensions (ASCS) can treat burns of varying depths with the advantage of reduced donor site wound burden. The current standard primary dressing for ASCS is a nonabsorbant, non-adherent, perforated film (control) which has limited conformability over heterogeneous wound beds and allows for run-off of the ASCS. To address these concerns, a novel spray-on polymer formulation was tested as a potential primary dressing in porcine deep partial thickness (DPT) and full thickness (FT) wounds. It was Burn wound healing hypothesized that the polymer would perform as well as control dressing when evaluating wound healing and scarring.

      DPT or FT wounds were treated with either a spray-on poly(lactic-co-glycolic acid) (PLGA) and poly(lactide-co-caprolactone) (PLCL) formulation or control ASCS dressings. Throughout the experimental time course (to day 50), we found no significant differences between polymer and control wounds in % re-epithelialization, graft-loss, epidermal or dermal thickness, or % dermal cellularity in either model. Pigmentation, erythema, elasticity, and trans-epidermal water loss (TEWL), were not significantly altered between the treatment groups, but differences between healing wounds/scars and un-injured skin were observed. No cytotoxic effect was observed in ASCS incubated with the PLGA and PLCL polymers.

      These data suggest that the novel spray-on polymer is a viable option as a primary dressing, with improved ease of application and conformation to irregular wounds. Polymer formulation and application technique should be a subject of future research.

American Society for Metabolic and Bariatric Surgery updated statement on single-anastomosis duodenal switch

Kara Kallies, M.S.*, Ann M. Rogers, M.D., F.A.C.S., F.A.S.M.B.S., for the American Society for Metabolic and Bariatric Surgery Clinical Issues Committee

Division of Minimally Invasive and Bariatric Surgery, Penn State Health, Hershey, Pennsylvania Received 16 March 2020; accepted 16 March 2020

*Correspondence: Kara Kallies, M.S., Penn State Health, 500 University Drive, Hershey, PA 17033.

E-mail address: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (K. Kallies).

自体表皮细胞悬液在修复皮肤组织缺损创面中的作用研究

吴昌炎·，房志强2，江宝华3，陈石海1

(1．广西医科大学附属第一医院整形美容科广西南宁5 30000；2．龙岩华美罗桥医院整形科；3．江苏省昆山市时光医疗美容医院)

[摘要]目的：探讨自体表皮细胞悬液在修复皮肤组织缺损创面的作用。方法：在2 o只大鼠身上分别取邮票大小自体全厚皮片进行消化，分离成单个表皮细胞的悬液；经传代培养后，使用自体表皮细胞悬液分别对2 0只大鼠背部表皮皮肤缺损创面进行覆盖移植，术后观察移植物成活率和植皮区收缩率，同时取移植物进行组织学观察；并与对照组2 o只自体愈合创面进行相互比较。结果：表皮细胞悬液移植后1周渐融合成片，伤1：2愈合；经6周后，伤口平整，轻度瘢痕愈合。而对照组在6周时伤口不平整，呈瘢痕愈合，色素沉着明显。结论：在表皮缺损创面上应用体外培养的自体表皮细胞悬液移植修复可达到重构皮肤的目的。

[关键词]移植：组织缺损；表皮细胞悬液；细胞培养；皮肤重建

[中图分类号]R622

[文献标识码]A

[文章编号]1 008—645 5(2012)12—2201- 03

Application of the Suspension of epidermal cell cultured in tissue defect

WU Chang—yanl，FANG Zhi—qian92,JIANG Bao—hua3,CHEN Shi—hall

(1．Department of Plastic Surgery，Fi rst Affiliated Hospital of Guangxi Medical University，Nanning 530021，Guangxi，China；2 Department of Plastic Surgery，Longyan Huamei Luoqiao Hospital；3 Department of Plastic Surgery，Kunshan Shiguang

Cosmetology Hospital)

Abstract：

Objective To repair the tissue defect by the Suspension of epidermal cell．

Methods a stamp—size of normal skin was harvested in forty rats and epidermal cells suspension was made th rough decomposing，digesting，culturing and re——digesting in lab．Then it Was implanted to the skin defects made on the dorsa of rats．Shrinkage of the graft survival rate was observed after grafting and samples were taken to make routine paraffin sections for microscopica||y examination，then compared with autogenous healing．

Results After Suspension of epidermal cell was cultured for one week．1he wounds healed gradually The surface of healing wounds was smooth with a slight scar three to six weaks later．But the surface of healing wounds of control group was uneven，scar healing and pigmentation was obvious

Conculsion In the skin defect On the application Of in vitro culture wound autologous skin celI suspension liquid transDlantatiOn to repair lhe purpose of lhe reconstruction of the skin．

Key words：transDIantatiOn：tissue defect；suspension Of epidermal cell；cellular culture；reconstruction Of human skin.

Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Socie

Jeffrey I. Mechanick, M.D.a,*, Adrienne Youdim, M.D.b , Daniel B. Jones, M.D., M.S.c,W. Timothy Garvey, M.D.d , Daniel L. Hurley, M.D.e , M. Molly McMahon, M.D.e,Leslie J. Heinberg, Ph.D.f , Robert Kushner, M.D.g , Ted D. Adams, Ph.D., M.P.H.h,Scott Shikora, M.D.i , John B. Dixon, M.B.B.S., Ph.D.j , Stacy Brethauer, M.D.k

a Co-Chair, Icahn School of Medicine at Mount Sinai, New York, New York

b Co-Chair, Cedars Sinai Medical Center, Los Angeles, California

c Co-Chair, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts

d Primary Writer, AACE, University of Alabama at Birmingham, Birmingham VA Medical Center, Birmingham, Alabama

e Primary Writer AACE, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota

f Primary Writer TOS, Cleveland Clinic Lerner College of Medicine, BMI Director of Behavioral Services, Cleveland, Ohio

g Primary Writer TOS, Northwestern University, Feinberg School of Medicine, Chicago, Illinois

h Primary Writer TOS, Health & Fitness Institute, Intermountain Healthcare and Cardiovascular Genetics Division,University of Utah School of Medicine, Salt Lake City, Utah

i Primary Writer ASMBS, Harvard Medical School, Center for Metabolic Health and Bariatric Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

j Primary Writer ASMBS, Professor and Head of Clinical Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, Australia

k Primary Writer ASMBS, Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio Received December 23, 2012; accepted December 27, 2012

Abstract

      The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the evidence and subjective factors per protocol. Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery for patients with mild obesity, copper deficiency, informed consent, and behavioral issues. There are 74 recommendations (of which 56 are revised and 2 are new) in this 2013 update, compared with 164 original recommendations in 2008. There are 403 citations, of which 33 (8.2%) are EL 1, 131 (32.5%) are EL 2, 170 (42.2%) are EL 3, and 69 (17.1%) are EL 4. There is a relatively high proportion (40.4%) of strong (EL 1 and 2) studies, compared with only 16.5% in the 2008 AACETOS-ASMBS CPG. These updated guidelines reflect recent additions to the evidence base. Bariatric surgery remains a safe and effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues. (Surg Obes Relat Dis 2013;9:159-191.) r 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Keywords: Bariatric surgery; Obesity; Metabolic surgery; Diabetes surgery; Metabolic syndrome; Clinical practice guidelines; Best practice guidelines; Weight loss surgery