慢性伤口治疗中普遍存在的问题？

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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

多份专业杂志编委
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最新文献

Effects of stabilized hypochlorous acid on oral biofilm bacteria 2026-08-28 00:00

Olivia Aherne^1,2, Roberto Ortiz² , Magnus M. Fazli^3,4 and Julia R. Davies^1*

Abstract

Background: Caries and periodontitis are amongst the most prevalent diseases worldwide, leading to pain and loss of oral function for those affected. Prevention relies heavily on mechanical removal of dental plaque biofilms but for populations where this is not achievable, alternative plaque control methods are required. With concerns over unde-sirable side-effects and potential bacterial resistance due to the use of chlorhexidine gluconate (CHX), new antimicrobial substances for oral use are greatly needed. Here we have investigated the antimicrobial effect of hypochlorous acid (HOCl), stabilized with acetic acid (HAc), on oral biofilms and compared it to that of CHX. Possible adverse effects of stabilized HOCl on hydroxyapatite surfaces were also examined.

Methods: Single- and mixed-species biofilms of six common oral bacteria (Streptococcus mutans, Streptococcus gordonii, Actinomyces odontolyticus, Veillonella parvula, Parvimonas micra and Porphyromonas gingivalis) within a flow-cell model were exposed to HOCl stabilized with 0.14% or 2% HAc, pH 4.6, as well as HOCl or HAc alone. Biofilm viability was assessed in situ using confocal laser scanning microscopy following LIVE/DEAD® BacLight™ staining. In-situ quartz crystal microbalance with dissipation (QCM-D) was used to study erosion of hydroxyapatite (HA) surfaces by stabilized HOCl.

Results: Low concentrations of HOCl (5 ppm), stabilized with 0.14% or 2% HAc, significantly reduced viability in multi-species biofilms representing supra- and sub-gingival oral communities, after 5 min, without causing erosion of HA surfaces. No equivalent antimicrobial effect was seen for CHX. Gram-positive and Gram-negative bacteria showed no significant differential suceptibility to stabilized HOCl.

Conclusions: At low concentrations and with exposure times which could be achieved through oral rinsing, HOCl stabilized with HAc had a robust antimicrobial activity on oral biofilms, without causing erosion of HA surfaces or affecting viability of oral keratinocytes. This substance thus appears to offer potential for prevention and/or treatment of oral biofilm-mediated diseases.

Keywords: Biofilm control, Oral disease, Caries, Periodontitis, Oral infection

Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial 2026-08-26 00:00

Julio Cesar Plata ^1,2, David Díaz-Báez ³, Nathaly Andrea Delgadillo ³, Diana Marcela Castillo ³, Yormaris Castillo ³ , Claudia Patricia Hurtado ², Yineth Neuta ³ , Justo Leonardo Calderón ³ and Gloria Inés Lafaurie ^3,*

1 Master’s Program in Dental Sciences, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; 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。

2 School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia; 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。

3 Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; 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。 (D.D.-B.); 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。 (N.A.D.); 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。 (D.M.C.); 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。 (Y.C.); 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。 (Y.N.); 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。 (J.L.C.)

* 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: Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. Objective: The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. Material and methods: A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges–Lehmann hypothesis test for non-inferiority. Results: HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. Conclusions: HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.

Keywords: chlorhexidine; antiplaque; bacterial recolonization; hypochlorous acid
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慢性伤口治疗中普遍存在的问题？

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12 10月 2019

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Author : 伤口世界

慢性伤口治疗中普遍存在的问题？

原创：卢魁

慢性伤口治疗中普遍是什么问题困扰着患者呢？

问题一：悲观思想，认为患了不治之症
事实上，精神压力和疾病之间，存在着一条明显的纽带。对疾病切勿忧虑恐惧，悲观失望，郁郁寡欢，闷闷不乐，要学会自我克制、自我调节，要心胸宽广，豁达大度，树立战胜疾病的信念，要有毅力和勇气。
问题二:
轻信广告和传言，相信“神药”
慢性伤口是一种长期慢性疾病，其中很多疾病都是没有办法完全根治的，因此必须要有长期和疾病做斗争的思想认识。切勿相信广告所说的秘方、神药，以免上当受骗，耽误病情。
问题三：
为什么症状控制后仍需要长期观察预防复发？
到目前为止，慢性伤口大部分尚不能根治，需要长期治疗让伤口愈合。症状减轻仅意味着病情得到控制，并未完全治愈。体内的病变可能并没有真正停止，停药后或受到外界刺激仍会复发。只有改变生活习惯、合理功能锻炼、合理使用控制病情的药物(慢作用药物)，才能减缓或阻止上述过程的进展。

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学术会议

2019广东省医疗行业协会伤口管理分会年会

扫一扫了解详情:

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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