糖尿病足的诊断（接上篇）

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糖尿病足

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Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

中德骨科伤口管理学校校长

广东省骨科研究院运动医学研究所所长

广东省内运动医学专业唯一的博士研究生导师

美国哈弗大学医学院骨科访问学者

专业特长处于省内领先、国内或国际先进水平以上

2018年获得“国之名医卓越建树”荣誉称号

2017年被评为全国卫生计生系统先进工作者、广东省医学领军人才

中国医师协会运动医师分会副会长

STCOT中国部运动医学分会副主任委员

广东省医学会关节外科分会主任委员

广东省医学会运动医学会分会名誉主任委员

独立承担过国家“863”课题，主持过10余项省、部级科研项目

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最新文献

Periprocedural Use of Hypochlorous Acid Mist for Improving Healing and Cosmesis of the Face After Laser 2026-11-07 00:00

Marianna Blyumin-Karasik¹ | Jessica Colon² | Sophie Gaer¹ | Isabella Vigil¹ | Sylvie Nguyen² | Jordan Rosen¹

¹Precision Skin & Body Institute, Davie, Florida, USA |²Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida, USA

Correspondence: Marianna Blyumin-Karasik (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。)

Received: 12 May 2025 | Revised: 7 August 2025 | Accepted: 12 August 2025

Funding: The authors received no specific funding for this work.

Keywords: aesthetic | cosmeceuticals | hypochlorous acid | integrated skincare | laser treatment | photoaging | resurfacing laser

ABSTRACT

Background: Laser resurfacing treatments have revolutionized dermatological procedures by improving skin texture, tone, and quality. Effective periprocedural care remains essential to reduce side effects, support healing, and optimize aesthetic outcomes. Hypochlorous acid (HOCl), a naturally occurring oxidant with anti-inflammatory and antimicrobial properties, has demonstrated efficacy in promoting wound healing and minimizing scarring.

Aim: To evaluate the use of stabilized HOCl mist in the periprocedural care of patients undergoing laser resurfacing.

Methods: Ten patients underwent treatment with UltraClear, CO2RE, and/or GentleMax Pro laser devices. Stabilized HOCl mist was applied before and after the procedure, with continued application twice daily for 1week posttreatment. Follow-up assessments at 1–3weeks and 1–3months post-procedure included clinical photography, tolerability evaluation, and aesthetic outcome assessment. Outcomes measured included Clinician Erythema Assessment (CEA), 4-point Edema Scale, Investigator Global Assessment of Pigmentation Scale (IPA), and Global Aesthetic Improvement Scale (GAIS). Statistical analysis was performed using the Friedman and Wilcoxon signed-rank tests.

Results: HOCl mist was associated with accelerated recovery, including a noticeable reduction in erythema and pigmentation. Statistically significant improvements were observed in CEA (p=0.007) and IPA (p=0.012) scores, indicating reduced clinical severity and pigment alteration. Edema and GAIS scores showed no statistically significant change.

Conclusion: Stabilized HOCl mist is well-tolerated and may significantly aid post-procedural recovery by minimizing side effects and reducing discomfort. Results support the potential role of stabilized HOCl mist as a beneficial adjunct in post-laser skincare, contributing to faster healing, reduced inflammation, and enhanced cosmetic results.

Effect of Sodium Hypochlorite 0.05% on MMP-9 Extracellular Release in Chronic Wounds 2026-11-06 00:00

Rosanna Maniscalco ¹, Giorgina Mangano ², Alessandra Capezzone de Joannon ^3,^*, Matteo Vergassola ³, Sara Zucchi ³, Ferdinando Mannello ¹ and Lorella Ragni ³

¹Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy

²Scientific Consultant, ToxHub S.r.l. Albano Laziale, 00073 Rome, Italy

³Global R&D Angelini Pharma S.p.A, Via Vecchia del Pinocchio, 22, 60131 Ancona, Italy

^*Correspondence: 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。

Abstract: Background: In chronic wounds, high concentrations of matrix metalloproteinases (MMPs) can cause excessive proteolysis and slow wound healing. Consequently, restoring a proper MMP balance can help reduce the risk of a chronic wound. An antiseptic solution containing 0.05% sodium hypochlorite (Amukine Med 0.05%, Angelini S.p.A.; hereafter termed NaClO solution) is available on the market. The NaClO solution was proven effective and safe in managing infected skin wounds. To further characterize its activity, this study evaluated the in vitro activity of the NaClO solution on the monocyte release of MMPs. Methods: Human monocytic THP-1 (ATCC® TIB-202™) cell lines were differentiated into macrophages and treated with different concentrations of NaClO (from 0.05% to 5 × 10−7%). In addition, the THP-1 cell line was stimulated with wound fluid (WF) from patients with active venous leg ulcers in the inflammatory phase. The effect of NaClO (0.025–0.0062%) was also evaluated on healthy human peripheral blood serum samples. The effects of treatments on the gelatinolytic activity of MMP-9 were evaluated by gelatin zymography. The effects on MMPs release were evaluated through the Pro™ Human MMP 9-plex Assay. An exploratory scratch wound healing assay was also performed. Results: The NaClO solution reduced the gelatinolytic activity of MMP-9 and its activated form. The downregulation of MMP-9 gelatinolytic activity was also observed in peripheral blood serum. The MMPs profile showed a reduction in MMP-1 release (p < 0.05) and a slight reduction of the release of MMP-9 and MMP-12 after the treatment with LPS and the NaClO solution. A slight improvement in wound healing was observed after macrophage activation and treatment with the NaClO solution. Conclusions: The results obtained suggest a possible ability of the NaClO solution to modulate the proteolytic pathways in the wound microenvironment, further characterizing its activity and use in clinical practice during wound care.

Keywords: sodium hypochlorite; matrix metalloproteinases inhibition; gelatinolytic activity; chronic wound
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糖尿病足的诊断（接上篇）

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18 10月 2019

Author : 伤口世界

原创：胡海涛负压引流与创面修复

世界卫生组织(WHO)定义:糖尿病足是指糖尿病患者由于合并神经病变及各种不同程度末梢血管病变而导致下肢感染、溃疡形成和(或)深部组织的破坏。

三个必须条件，缺一不可：

糖尿病患者；
合并神经病变及不同程度末梢血管病变；
下肢感染、溃疡形成或深部组织坏死；

该患者疼痛明显、足背动脉博动好，不符合糖尿病足诊断标准2、3，所以排除糖尿病足诊断。伤口内见到痛风石、CT看到切口区域关节周围痛风结节较多，按痛风结节诊治方案处理，伤口愈合。

糖尿病足鉴别诊断：糖尿病患者合并痛风结节破溃、下肢动脉硬化闭塞、血栓闭塞性脉管炎等。

最后提醒：遇到糖尿病患者足溃疡时，第一步是诊断，第二步是鉴别诊断，尤其当治疗效果不好时，得再次思考这两个问题。

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Periprocedural Use of Hypochlorous Acid Mist for Improving Healing and Cosmesis of the Face After Laser 2026-11-07 00:00

Marianna Blyumin-Karasik¹ | Jessica Colon² | Sophie Gaer¹ | Isabella Vigil¹ | Sylvie Nguyen² | Jordan Rosen¹

¹Precision Skin & Body Institute, Davie, Florida, USA |²Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida, USA

Correspondence: Marianna Blyumin-Karasik (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。)

Received: 12 May 2025 | Revised: 7 August 2025 | Accepted: 12 August 2025

Funding: The authors received no specific funding for this work.

Keywords: aesthetic | cosmeceuticals | hypochlorous acid | integrated skincare | laser treatment | photoaging | resurfacing laser

ABSTRACT

Background: Laser resurfacing treatments have revolutionized dermatological procedures by improving skin texture, tone, and quality. Effective periprocedural care remains essential to reduce side effects, support healing, and optimize aesthetic outcomes. Hypochlorous acid (HOCl), a naturally occurring oxidant with anti-inflammatory and antimicrobial properties, has demonstrated efficacy in promoting wound healing and minimizing scarring.

Aim: To evaluate the use of stabilized HOCl mist in the periprocedural care of patients undergoing laser resurfacing.

Methods: Ten patients underwent treatment with UltraClear, CO2RE, and/or GentleMax Pro laser devices. Stabilized HOCl mist was applied before and after the procedure, with continued application twice daily for 1week posttreatment. Follow-up assessments at 1–3weeks and 1–3months post-procedure included clinical photography, tolerability evaluation, and aesthetic outcome assessment. Outcomes measured included Clinician Erythema Assessment (CEA), 4-point Edema Scale, Investigator Global Assessment of Pigmentation Scale (IPA), and Global Aesthetic Improvement Scale (GAIS). Statistical analysis was performed using the Friedman and Wilcoxon signed-rank tests.

Results: HOCl mist was associated with accelerated recovery, including a noticeable reduction in erythema and pigmentation. Statistically significant improvements were observed in CEA (p=0.007) and IPA (p=0.012) scores, indicating reduced clinical severity and pigment alteration. Edema and GAIS scores showed no statistically significant change.

Conclusion: Stabilized HOCl mist is well-tolerated and may significantly aid post-procedural recovery by minimizing side effects and reducing discomfort. Results support the potential role of stabilized HOCl mist as a beneficial adjunct in post-laser skincare, contributing to faster healing, reduced inflammation, and enhanced cosmetic results.
Effect of Sodium Hypochlorite 0.05% on MMP-9 Extracellular Release in Chronic Wounds 2026-11-06 00:00

Rosanna Maniscalco ¹, Giorgina Mangano ², Alessandra Capezzone de Joannon ^3,^*, Matteo Vergassola ³, Sara Zucchi ³, Ferdinando Mannello ¹ and Lorella Ragni ³

¹Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy

²Scientific Consultant, ToxHub S.r.l. Albano Laziale, 00073 Rome, Italy

³Global R&D Angelini Pharma S.p.A, Via Vecchia del Pinocchio, 22, 60131 Ancona, Italy

^*Correspondence: 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。

Abstract: Background: In chronic wounds, high concentrations of matrix metalloproteinases (MMPs) can cause excessive proteolysis and slow wound healing. Consequently, restoring a proper MMP balance can help reduce the risk of a chronic wound. An antiseptic solution containing 0.05% sodium hypochlorite (Amukine Med 0.05%, Angelini S.p.A.; hereafter termed NaClO solution) is available on the market. The NaClO solution was proven effective and safe in managing infected skin wounds. To further characterize its activity, this study evaluated the in vitro activity of the NaClO solution on the monocyte release of MMPs. Methods: Human monocytic THP-1 (ATCC® TIB-202™) cell lines were differentiated into macrophages and treated with different concentrations of NaClO (from 0.05% to 5 × 10−7%). In addition, the THP-1 cell line was stimulated with wound fluid (WF) from patients with active venous leg ulcers in the inflammatory phase. The effect of NaClO (0.025–0.0062%) was also evaluated on healthy human peripheral blood serum samples. The effects of treatments on the gelatinolytic activity of MMP-9 were evaluated by gelatin zymography. The effects on MMPs release were evaluated through the Pro™ Human MMP 9-plex Assay. An exploratory scratch wound healing assay was also performed. Results: The NaClO solution reduced the gelatinolytic activity of MMP-9 and its activated form. The downregulation of MMP-9 gelatinolytic activity was also observed in peripheral blood serum. The MMPs profile showed a reduction in MMP-1 release (p < 0.05) and a slight reduction of the release of MMP-9 and MMP-12 after the treatment with LPS and the NaClO solution. A slight improvement in wound healing was observed after macrophage activation and treatment with the NaClO solution. Conclusions: The results obtained suggest a possible ability of the NaClO solution to modulate the proteolytic pathways in the wound microenvironment, further characterizing its activity and use in clinical practice during wound care.

Keywords: sodium hypochlorite; matrix metalloproteinases inhibition; gelatinolytic activity; chronic wound
Hypochlorous Acid for Wound Healing in Diabetic Rats: Effect on MMP-9 and Histology 2026-11-05 00:00

Dita Mutiara Irawan ¹, Ronny Lesmana^2–4 , Edhyana Sahiratmadja ⁴

¹Graduate School of Master Program in Anti Aging and Aesthetic Medicine, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, 45363, Indonesia; ²Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, 45363, Indonesia; ³ Division of Biological Activity, Central Laboratory, Universitas Padjadjaran, Sumedang, 45363, Indonesia; ⁴ Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia

Correspondence: Dita Mutiara Irawan, Email 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。

Background: People who suffered type 2 diabetes have impaired healing of wounds due to the large number of circulating inflammatory cells resulting from high blood sugar levels. The wound healing process involves various complex processes including the degradation of extracellular matrix, a process characterized by an increase in matrix metalloproteinase-9 (MMP-9). Conventional management of diabetic wounds usually involves systemic blood sugar control and topical antimicrobial treatment, including hydrogen peroxide and povidone-iodine, which are known to be cytotoxic to the cells involved in the wound healing cascade. Finding a safe, non-toxic, and effecting wound cleansing still poses a challenge, and hypochlorous acid (HOCl) could act as a potential candidate.

Purpose: Unveiling an HOCl ion as an agent for diabetic wound management and MMP-9 as a marker for delayed diabetic wound

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram is used to find and select related, eligible literatures for the review. The authors used several databases such as Pro Quest, Scopus, Springer link an Science Direct. In addition, and to expand the data, the database on Google Scholar was also opened. Then, the compiled data are analyzed to form results and discussions to the research question.

Results: Five eligible articles passed the inclusion criteria and reviewed for data synthesis. From 5 pieces of literature, it was found that the use of HOCl ions can be a good choice of topical agent in the management of diabetic wounds and decrease the activity of MMP-9, which act as a marker for delayed healing of diabetic wounds.

Conclusion: Topical agent, in this case HOCl ion, shows good results and can be used as an option in the management of diabetic wounds and MMP-9 can be used as a predictive marker in the management of diabetic wounds.

Keywords: diabetic wound, HOCl ion, hypochlorite acid, MMP-9, wound healing

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2019广东省医疗行业协会伤口管理分会年会

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2019年6月15日中国广州
主办单位：广东省医疗行业协会伤口管理分会

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Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长