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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

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

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.

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).