伤口世界
- 星期一, 21 11月 2022
负压封闭引流技术在临床应用中生物机制 研究
杨 榕1 ，思 飞2 ，李宜橙1 ，李 明3*
*通讯作者。
1 延安大学附属医院，陕西 延安 2 中国人民解放军总医院京东医疗区，北京 3 延安大学附属医院烧伤整形手外科，陕西 延安
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收稿日期：2021年1月7日；录用日期：2021年1月29日；发布日期：2021年2月19日
摘 要
负压封闭引流技术(VSD)是临床上引入的一种治疗急、慢性创面的处理技术。目前认为VSD在创面修复中与透明质酸的代谢、CD44的表达、巨噬细胞趋化、肉芽组织生长等机制有关。上述机制相互促进，使创面愈合时间明显缩短，有效改善创面愈合处的色素沉着，尽量减少或避免对皮肤美观度的影响。本文将对负压封闭引流技术在针对临床应用中的生物机制加以研究，希望对后期创面修复及诊疗效果提供一定指导意义。
关键词： 负压封闭引流，创面修复，透明质酸，巨噬细胞，肉芽组织
文章引用: 杨榕, 思飞, 李宜橙, 李明. 负压封闭引流技术在临床应用中生物机制研究[J]. 临床医学进展, 2021, 11(2): 490-496. DOI: 10.12677/acm.2021.112070
Study on Biological Mechanism of Vacuum Sealing Drainage in Clinical Application
Rong Yang1, Fei Si2, Yicheng Li1, MingLi3*
1 Affiliated Hospital of Yan’an University, Yan’an Shaanxi
2 People’s Liberation Army General Hospital Jingdong Medical Area, Beijing
3 Department of Burn Plastic Surgery, Affiliated Hospital of Yan’an University, Yan’an Shaanxi
Abstract
Vacuum sealing drainage (VSD) is a clinically introduced treatment technology for acute and chronic wounds. It is currently believed that VSD is related to hyaluronic acid metabolism, CD44 expression, macrophage chemotaxis, granulation tissue growth and other mechanisms in wound repair. The above mechanisms promote each other, shorten the healing time of the wound, effectively improve the pigmentation at the wound healing, and minimize or avoid the influence on the skin appearance. This article will study the biological mechanism of negative pressure sealing drainage technology in clinical application, hoping to provide a certain guiding significance for later wound repair and diagnosis and treatment.
Keywords: Vacuum Sealing Drainage, Wound Repair, Hyaluronic Acid, Macrophagocyte, Granulation Tissue
Copyright © 2021 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
- 星期四, 17 11月 2022
负压伤口滴注疗法治疗慢性难愈性创面的研究进展
刘亚平，晁生武*
*通讯作者。
青海大学附属医院烧伤科，青海 西宁
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收稿日期：2021年7月16日；录用日期：2021年8月13日；发布日期：2021年8月20日
文章引用: 刘亚平, 晁生武. 负压伤口滴注疗法治疗慢性难愈性创面的研究进展[J]. 临床医学进展, 2021, 11(8):
3562-3567. DOI: 10.12677/acm.2021.118520
摘 要
负压伤口滴注疗法(NPWTi)是负压伤口疗法(NPWT)进一步的发展，近年来广泛应用于各种慢性难愈性创面，该技术的实用性及疗效也受到临床医师的认可。本文通过归纳概括NPWTi的作用机制，总结NPWTi的最新国内外研究进展，分析该技术的优点及可能存在的问题，旨在为慢性难愈性创面的治疗提供思路与帮助。
关键词: 负压伤口滴注疗法，冲洗治疗，难愈性创面，作用机制
Research Progress of NPWTi in the Treatment of Chronic Refractory Wounds Yaping Liu, Shengwu Chao*
Department of Burns and Plastic Surgery, Qinghai University Affiliated Hospital, Xining Qinghai
Received: Jul. 16th, 2021; accepted: Aug. 13th, 2021; published: Aug. 20th, 2021
Abstract
Negative-pressure wound therapy with instillation (NPWTi) is a further development of negative
pressure wound therapy (NPWT). In recent years, it has been used in various chronic refractory wounds. The practicality and efficacy of this technology have also been recognized by clinicians.
This article generalizes the mechanism of NPWTi, summarizes the latest research progress of NPWTi at home and abroad, analyzes the advantages and potential problems of the technology, aiming to provide ideas and help for the treatment of chronic refractory wounds.
Keywords: Negative-Pressure Wound Therapy with Instillation, Instillation Therapy, Refractory Wounds, Mechanisms
Copyright © 2021 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
- 星期三, 16 11月 2022
一例3级糖尿病足伴下肢闭塞患者火龙罐应用 的个案报道
李 凤* ，曾艳花#
珠海市中西医结合医院内分泌科，广东 珠海
收稿日期：2021年12月13日；录用日期：2022年1月21日；发布日期：2022年1月27日
* 第一作者。
# 通讯作者。
文章引用: 李凤, 曾艳花. 一例 3 级糖尿病足伴下肢闭塞患者火龙罐应用的个案报道[J]. 中医学, 2022, 11(1): 145-154.
DOI: 10.12677/tcm.2022.111026
摘 要
目的：对一例3级糖尿病足伴下肢闭塞患者火龙罐应用效果进行个案分析报道。方法：对患者采用护理步骤(评估、诊断、目标、措施、评价)应用火龙罐进行护理与评估，在应用过程中不断评估患者的康复情况，总结效果。结果：本次顺利完成一例3级糖尿病足伴下肢闭塞患者火龙罐应用的效果评估，且取得良好效果。结论：3级糖尿病足伴下肢闭塞患者火龙罐的应用中患者糖尿病足症状明显好转并逐渐康复，同时其下肢闭塞的侧支已形成，因此充分证明火龙罐在糖尿病足伴下肢闭塞患者的治疗及护理方面疗效显著，同时火龙罐的应用具有明显优势。
关键词：3级糖尿病足，火龙罐，个案报道
A Case Report of a Grade 3 Diabetic with Foot Occlusion and Lower Limb Occlusion Using Fire Dragon Pot
Feng Li*, Yanhua Zeng#
Department of Endocrinology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai Guangdong
Received: Dec. 13th, 2021; accepted: Jan. 21st, 2022; published: Jan. 27th, 2022
Abstract
Objective: The objective is to analyze and report the application effect of fire dragon pot in grade 3 diabetic foot with lower limb occlusion. Methods: Patients were nursed and evaluated with fire dragon pot in the nursing steps (evaluation, diagnosis, objective, measures, evaluation). The rehabilitation of patients was continuously evaluated in the application process, and the effect was summarized. Results: This time successfully completed a grade 3 diabetic foot with lower limb occlusion effect evaluation of fire dragon pot application, and achieved good results. Conclusion: 3 patients with lower limb occlusion with diabetic foot dragon tank used in patients with diabetic foot symptoms improved significantly the occlusion of lower limbs and recovery, and at the same time its collateral has formed so that fire dragon pot in the treatment of patients with diabetic foot with lower limb occlusion and nursing curative effect is distinct, and fire dragon pot has obvious advantages in application.
Keywords
Grade 3 Diabetic Foot, Fire Dragon Pot, Case Reports
Copyright © 2022 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
- 星期二, 15 11月 2022
Marjolin’s Ulcer at the Kara Teaching Hospital (Togo)
Tchaa Hodabalo Towoezim1, Tamegnon Dossouvi2*, Yaovi Yanick Dellanh3, Kokou Kanassoua2,
Irokoura Kassegne4, Pio-Faré Gnandi1, Anani Abalo5, Ekoué David Dosseh6
1 Department of Traumatology, Teaching Hospital of Kara, University of Kara, Kara, Togo
2 Department of General Surgery, Teaching Hospital of Kara, University of Kara, Kara, Togo
3 Department of Traumatology, Regional Hospital of Sokodé, University of Lomé, Lomé, Togo
4 Department of General Surgery, Regional Hospital of Kara, University of Kara, Kara, Togo
5 Department of Traumatology, Sylvanus Olympio Teaching Hospital of Lomé-Togo, University of Lomé, Lomé, Togo
6 Department of General Surgery, Sylvanus Olympio Teaching Hospital of Lomé-Togo, University of Lomé, Lomé, Togo
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How to cite this paper: Towoezim, T.H., Dossouvi, T., Dellanh, Y.Y., Kanassoua, K., Kassegne, I., Gnandi, P.-F., Abalo, A. and Dosshe, E.D. (2022) Marjolin’s Ulcer at the Kara Teaching Hospital (Togo). Surgical Science, 13, 34-39.
https://doi.org/10.4236/ss.2022.131006
Received: September 17, 2021
Accepted: January 22, 2022
Published: January 25, 2022
Copyright © 2022 by author(s) and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Abstract
Marjolin’s ulcer is an aggressive tumor that occurs on a chronic non-healing wounds or burn scars. It’s a rare disease. Histologically, it is most often a squamous cell carcinoma. The real frequency is not known. Its incidence would be higher in developing countries where ancestral beliefs and financial difficulties cause consultation delays. Thus the diagnosis is delayed, due in part to the lack or insufficiency of diagnostic means. Our study aimed to describe the epidemiological, diagnostic and therapeutic particularities through three cases treated in our center. The delay in consultation resulted in the death of one patient, while for the other two, amputation prevented the extension of the tumor. Limb amputation is increasingly rare in the management of Marjolin’s ulcer, but in our difficult conditions it is still widely practiced when the tumor is localized at the extremity of the limb, without signs of remote invasion.
Keywords
Ulcer, Marjolin, Cancer, Squamous Cell Carcinoma, Amputation
- 星期一, 14 11月 2022
Ji Desheng Snake Pills Combined with Hypertonic Glucose External Application in the Treatment of Stage III and IV Pressure Injuries
Rongting Liu1, Cong Zhang2, Jing Zeng3, Xue Wu1, Shihong Deng1, Jing Chen1*
1 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Yangtze University, Jingzhou, China
2 Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Yangtze University, Jingzhou, China
3 Department of Orthopaedic Surgery, The First Affiliated Hospital of Yangtze University, Jingzhou, China
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How to cite this paper: Liu, R.T., Zhang, C., Zeng, J., Wu, X., Deng, S.H. and Chen, J. (2021) Ji Desheng Snake Pills Combined with Hypertonic Glucose External Application in the Treatment of Stage III and IV Pressure Injuries. Yangtze Medicine, 5, 117-124. https://doi.org/10.4236/ym.2021.52012
Received: August 10, 2020
Accepted: April 12, 2021
Published: April 15, 2021
Copyright © 2021 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background: As a common surgical disease, pressure injury has become a long-standing problem in clinical treatment and nursing process. This research was conducted to explore the feasibility of Ji Desheng Snake Pills combined with hypertonic glucose external application in the treatment of stage III and IV pressure injuries.
Methods: Patients with stage III and IV pressure injuries, who received treatment in our hospital between December 2018 and December 2019 were selected and divided into experimental group, conventional treatment group, and control group, 30 cases for each. The three groups received Ji Desheng Snake Pills combined with hypertonic glucose external application, moist dressing external application and surgical dressing change, respectively. The safety, therapeutic effect and cost benefit of the three treatment methods were compared.
Results: There were no adverse reactions in the three groups of patients. The PUSH scores of the experimental group and the conventional treatment group were significantly lower than that of the control group on the 14th, 21th, and 28th days, and the result was statistically significant (p < 0.05), while there was no significant difference between the experimental group and the conventional treatment group (p >0.05). The wound healing rates of the experimental group (70.14 ± 8.27%) and the conventional treatment group (73.99 ± 7.15%) were significantly higher than that of the control group (43.25 ± 8.53%) on the 28th day, with statistical significance (p < 0.05); there was no significant difference between the experimental group and the conventional treatment group (p > 0.05). The total treatment costs of the three groups were 569.73 ± 78.12 yuan, 1043.40 ± 135.31 yuan, and 186.47 ± 30.29 yuan. The cost of the conventional treatment group was the highest, followed by the experimental group, and the control group was the lowest. The result was statistically significant (p < 0.05).
Conclusion: In the treatment of stage III and IV pressure injuries, there was no significant difference in the safety and therapeutic effect between the experimental group (Ji Desheng Snake Pills combined with hypertonic glucose external application) and the conventional treatment group (moist dressing external application), but the experimental group had better cost benefit.
Keywords
Ji Desheng Snake Pills, Hypertonic Glucose, Pressure Ulcer, Pressure Ulcer Scale for Healing Tool
- 星期五, 11 11月 2022
Five-Year Surveillance of Central Line Associated Bloodstream Infection in an Intensive Care Unit Population—A Retrospective Analysis
Theresia Lutufyo1,2 , Yuan Li2, Hui Han2, Weidong Qin2, Geofrey Mahiki Mranda1,3,
Xiaomei Chen1,2
1 Shandong University Cheelo College of Medicine, Jinan, China
2 Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
3 Department of Gastrointestinal Surgery, The Second Hospital of Shandong University, Jinan, China
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How to cite this paper: Lutufyo, T., Li, Y., Han, H., Qin, W.D., Mranda, G.M. and Chen, X.M. (2022) Five-Year Surveillance of Central Line Associated Bloodstream Infection in an Intensive Care Unit Population—A Retrospective Analysis. Advances in Infectious Diseases, 12, 281-297.
https://doi.org/10.4236/aid.2022.122023
Received: April 27, 2022
Accepted: June 7, 2022
Published: June 10, 2022
Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Abstract
Background: Central venous catheters (CVCs) are essential to current intensive care unit (ICU) practices as a tool for treating critically ill patients. However, the use of CVCs is associated with substantial risk of infection. Central line associated bloodstream infection (CLABSI) is increasing in prevalence each year and is among the major causes of bloodstream infection in ICU patients. Therefore, investigating the epidemiology and risk factors of CLABSI in ICU patients is important. Objective: This study aimed to investigate the incidence rates, causative pathogens and risk factors of CLABSI in an ICU population. Methods: A retrospective observational study was performed in an ICU at Qilu Hospital of Shandong University in China from January 2016 to December 2020. Patients with at least one CVC were enrolled, and information relevant to CVC use was recorded. The prevalence was calculated, and related risk factors were analyzed. Results: A total of 1920 catheters were identified, 507 of which were eligible for analysis. For each of the years 2016-2020, the incidence rates of CLABSI were 1.91, 3.18, 1.69, 2.97 and 1.27 per 1000 catheter days, respectively. The yeast Candida albicans was the most prevalent pathogen (16 [(3.2%]), followed by Gram-positive methicillin-resistant Staphylococcus aureus (11 [2.2%]) and the Gram-negative multidrug-resistant pathogen Acinetobacter baumanii. Risk factors associated with CLABSI development were age, (p = 0.05), Charlson comorbidity index > 5 (p < 0.01) and duration of CVC placement (p = 0.01). Conclusion: Candida albicans was the most common causative microorganism, which was followed by Gram positive methicillin resistant Staphylococcus, MDR K. pneumoniae and Acinetobacter baumanii.
Keywords Central Venous Catheter, Insertion Site, Bloodstream Infection, ICU, Catheter Days
