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1.
Full-thickness skin wounds were created on the dorsum of both metacarpi in 8 horses. Three topical treatment regimens were studied. All wounds were bandaged with a nonadherent dressing, which was held in place with a snug elastic wrap. Group-A wounds were treated with a proprietary topical wound medication that consisted of a spray and an ointment. Group-B wounds were treated with the same regimen, except the putative active ingredients in the ointment were omitted. Group-C wounds were treated with a dry nonadherent bandage only. Wound dressings were changed every day and the limbs were photographed every other day until the wounds were healed. Specimens of normal skin and biopsy specimens of healed wounds were examined histologically and were assayed for hydroxyproline content. Wound healing measurements quantitated for each wound were number of days to healing, maximal wound size attained, day wound contraction commenced, day epithelium first noticed, rate of wound contraction, final wound size, and fraction of the wound that healed by contraction. The cosmetic appearance of the healed wounds was also graded. Significant differences were not noticed in hydroxyproline content, histologic appearance, or any of the wound healing measurements between treatment groups. The cosmetic appearance of healed group-A and -B wounds was significantly better than the appearance of group-C wounds. The topical treatment regimens studied neither enhanced nor inhibited wound healing in this study.  相似文献   

2.
OBJECTIVE: To describe the macroscopic features of first and second intention cutaneous wound healing in the cat and compare with the dog. STUDY DESIGN: Experimental study. ANIMALS: Domestic shorthaired cats (6) and beagle dogs (6). METHODS: Square, open cutaneous wounds created on the dorsal aspect of the thorax were evaluated for 21 days for temporal and spatial development of granulation tissue, wound contraction, epithelialization, and total healing. To evaluate first intention healing, breaking strength of sutured linear cutaneous wounds was measured at 7 days post-wounding. Laser-Doppler perfusion imaging was used to measure cutaneous perfusion. RESULTS: First intention healing: sutured wounds in cats were only half as strong as those in dogs at day 7 (0.406 versus 0.818 kg breaking strength). Second intention healing: cats produced significantly less granulation tissue than dogs, with a peripheral, rather than central distribution. Wound epithelialization and total wound healing (total reduction in open wound area from contraction and epithelialization) were greater for dogs than for cats over 21 days. Wound contraction on day 7 was greater for dogs, but not on day 14 or 21. Cutaneous perfusion was initially greater for dogs than for cats, but no differences were detected after day 7. CONCLUSIONS: Significant, previously unreported differences in cutaneous wound healing exist between cats and dogs. In general, cutaneous wounds in cats are slower to heal. Cats and dogs also appear to use different mechanisms of second intention healing. In cats wounds close mainly by contraction of the wound edges, whereas in dogs wounds close more from central pull, and epithelialization. CLINICAL RELEVANCE: Surgeons should view the cat as a unique species, which presents its own special challenges in wound healing, and should take this into account when planning treatment of feline wounds, either by primary closure, or by second intention healing.  相似文献   

3.
Preformed collagen gel was topically applied to cutaneous wounds of the equine dorsal fetlock (thoracic limb) and metatarsal regions to evaluate the effect on exuberant granulation tissue production and wound healing. In 6 horses and 3 ponies (less than 140 cm high at the withers and less than 365 kg), 36 standardized cutaneous limb wounds were surgically induced (4 wounds/animal); 18 wounds were treated topically with collagen gel, and 18 wounds were not treated (controls). Collagen gel was initially applied to the wound at 0, 2, or 7 days after wound formation (groups 1, 2, and 3, respectively). Four measurements were regularly made: amount of wound contraction and the size of the granulation bed, epithelial covering, and total wound. Sequential skin and wound biopsies were evaluated histologically to assess wound healing. Using a computer, data were analyzed for differences in the 4 measurements between treated and control wounds, between fetlock wounds and metatarsal wounds, and among groups 1, 2, and 3. Analyses were performed on days 15 and 45 of wound healing and on the final day of healing. A significant difference (P greater than 0.05) in the production of exuberant granulation tissue, rate of epithelialization, or degree of wound contraction was not detected between the collagen-treated and control wounds. Total healing time and final scar size were similar. Wound healing patterns were significantly different (P less than 0.05) in the fetlock wounds and metatarsal wounds. All wounds enlarged up to day 15 with fetlock wounds enlarging significantly more than did the metatarsal wounds.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

4.
Topical oxygen therapy (TOT) has been used in human medicine to promote healing in chronic wounds. To test the efficacy and safety of TOT in horses, an experimental wound model was created by making 1 standardized dermal wound on each limb of 4 healthy horses (n = 16). Each wound was fitted with an oxygen delivery cannula and covered with a bandage. One limb of each front and hind pair was randomly assigned to the treatment group (fitted with an oxygen concentrator device), with the contralateral limb assigned to the control group (no device). Wound area, epithelial area, and contraction were measured every 3 to 4 d. Biopsy samples and culture swabs were taken on days 16 and 32 to evaluate angiogenesis, fibroplasia, epithelial hyperplasia, inflammation and bacterial growth. Mean healing time in treated wounds (45 d, range: 38 to 52 d) was not significantly different from that in the paired control wounds (50 d, range: 38 to 62 d). Topical oxygen therapy had little effect on dermal wound healing in this experimental wound model in healthy horses.  相似文献   

5.
The effects of topical administration of polysaccharides isolated from fungus, Phellinus gilvus (PG) on the healing of rat dermal wounds were assessed. In 10 Sprague-Dawley (SD) rats, six 6 mm diameter defects were made with a punch biopsy appliance. After 24 hr, test substances were applied to the defects twice a day: 0.025, 0.25, and 2.5% polysaccharides from PG (PG0.025, 0.25, and 2.5 groups), Madecassol ointment (MC group), aqueous gel (AG group) and no treatment (control group). Six days postoperatively, the contraction and reepithelialization of the wound surface were assessed. Wound diameter was significantly reduced in all PG groups (P<0.05). Complete epithelialization and macrophages were noted in the PG0.25 group, as compared to the control group. We conclude that polysaccharides isolated from PG have significant dermal wound healing effects, and this investigation suggests the potential clinical application of PG as a wound healing agent.  相似文献   

6.
Background A two‐part study examined wound healing and contraction occurring after mulesing and two alternative methods of preventing breech flystrike in sheep. Objective To quantify wound healing using a scoring system and to assess the contractility of the wound bed of the breech after mulesing, cetrimide‐intradermal treatment and application of clips. Method The study group of 30 mulesed, 30 cetrimide‐intradermal treated, 30 control and 10 clip‐treated sheep were humanely killed at six time points from 3 to 47 days after each treatment. Wound healing post treatment was assessed using a scoring system, and contractility was assessed by the quantification of myofibroblast expression. Statistical analyses allowed comparisons of temporal wound healing and contraction between treatment groups. Results Mulesing wounds healed faster in the first 11 days, but by 19 days wound healing was similar between the mulesing and cetrimide‐intradermal groups. By 32 days, all three treatment groups had similar wound healing scores. There was greater myofibroblast expression in the mulesing group in the first 11 days after treatment, but by 19 days expression was similar in both the mulesing and cetrimide‐intradermal groups. The clip group had significantly less myofibroblast expression from 32 days after treatment. Conclusion Wound healing is initially most rapid after mulesing, but there are similar wound healing scores in the mulesing and cetrimide‐intradermal treatment groups by 19 days. Both mulesing and the cetrimide‐intradermal treatment induce a similar amount of wound bed contraction, with less contraction observed after application of clips.  相似文献   

7.
The effects of ambient temperature (13.5 degrees C, 21 degrees C, 30 degrees C) and type of wound on healing of skin wounds were evaluated in common garter snakes (Thamnophis sirtalis). Linear unsutured incisions and circular excisional wounds were evaluated grossly and microscopically in three snakes held at each temperature at each of two, five and ten days after surgery. Linear sutured and unsutured incisions and circular and square excisional wounds were similarly evaluated three and six weeks after wound production in groups of six snakes held at each temperature. The rates of stabilization of wound margins, scab formation, migration and maturation of the regenerating epithelium, resolution of dermal inflammation, and fibroplasia varied directly with temperature. The inflammatory reaction to wounding was similar in character and intensity in snakes held at all three temperatures two days after surgery. Unsutured linear incisions, compared to sutured incisions, tended to have more rapid epithelial maturation and a less intense inflammatory response. Healing of square and circular excisional wounds was similar; contraction of round wounds was slightly more irregular and, at a few observations, dermal maturation was slower and inflammation more widespread. It was concluded that healing of skin wounds can be accelerated by holding reptiles at the upper end of their voluntary temperature range. Wounds, if possible, should be created along the axis of lines of skin tension. Suturing small incisional wounds may not be advantageous.  相似文献   

8.
Magnetic fields have been considered for treating many ailments over man's history. There have been many anecdotal unsupported claims for successful treatment of soft tissue injury although reports have been more substantive in the orthopaedic field. The widespread clinical and veterinary use of a light self-adhesive magnetic foil in Europe prompted this trial of experimental wound healing. One hundred and sixty Sprague-Dawley rats had a linear 2.5 cm incision or a circular 1 cm skin defect made over the mid-dorsal spine. Equal numbers were randomised to receive either a magnetic foil or a dummy (control) dressing. At three, seven, 10 or 14 days linear wounds were distracted using a tensiometer; open defects were measured, excised and assayed for collagen content; 14-day wounds were examined histologically. Although wound tensile strengths increased and open wounds decreased in size with increase of hydroxyproline, there were no statistically significant differences between treated or control animals. Although easy to apply the alternate magnetic foil (giving 400 Gauss at 7 mm) conferred no statistically significant effect on soft tissue healing.  相似文献   

9.
REASONS FOR PERFORMING STUDY: The acceptance of skin grafts in horses is unpredictable and the final cosmetic result can be disappointing. Besides movement and infection, graft failure is often caused by chronic inflammation, inherently present during second intention healing of limb wounds in horses. In human burns affected by infection and inflammation, the acceptance of the island skin grafts of the modified Meek technique appeared to be better than meshed sheet skin grafts. HYPOTHESIS: The percentage take of Meek micrografts is higher than of other techniques; and rates of both wound contraction and epithelialisation are increased. METHODS: Large traumatic limb wounds of 13 horses healing by second intention were grafted using the modified Meek technique. Photographs of the wounds were taken at set intervals. Wound areas, and areas of acceptance and rejection were determined using a digital image post processor (Scion Image). The percentages of take, wound contraction and epithelialisation were calculated. RESULTS: The initial mean wound area was 7500 mm2. Graft acceptance was mean +/- s.d. 93.7 +/- 5.9%. Wound closure was due to contraction (55.2 +/- 11.1%) and epithelialisation (44.8 +/- 11.1%) and resulted in a 96.7 +/- 3.6% reduction of the initial wound area 29.1 +/- 6 days after grafting. All wounds showed functional and cosmetic healing. CONCLUSIONS: The method for skin grafting in horses achieved higher percentages of take than reported previously and consistent cosmetic and functional results. The grafts increased not only the rate of epithelialisation but also had a strong positive effect on wound contraction, resulting in rapid closure and smaller scars. POTENTIAL RELEVANCE: The modified Meek technique proved to be a novel technique for skin grafting equine wounds in clinical practice, which can be performed easily. The molecular background of the increase of wound contraction by the grafts may provide a clue in the search for medicinal stimulation of wound contraction during second intention healing.  相似文献   

10.
Objective— To describe and compare the contribution of the subcutaneous tissues to 1st and 2nd intention cutaneous wound healing in the dog and cat.
Study Design— Experimental study.
Animals— Domestic shorthaired cats (n=6) and 6 beagle dogs.
Methods— Paired wounds were created on either side of the dorsal midline; the subcutaneous tissue was removed on 1 side and left intact on the other. Square, open wounds of the dorsal aspect of the thorax were observed for 21 days to monitor granulation tissue formation, wound contraction, epithelialization, and total healing (contraction+epithelialization). Breaking strength of sutured linear wounds was measured 7 days after wounding. Laser-Doppler perfusion imaging (LDPI) was used to measure cutaneous perfusion.
Results— First intention healing: subcutaneous tissue removal had no consistent effect on sutured wound strength at 7 days in dogs or cats. Second intention healing: removal of subcutaneous tissue reduced wound perfusion, granulation, contraction, epithelialization, and total healing. Granulation tissue formation and wound contraction were delayed to a significantly greater degree in cats than in dogs ( P <.05). Two dogs (33%) had minor wound infections.
Conclusions— The subcutaneous tissues make an important contribution to 2nd intention cutaneous healing. Dog and cat wounds had delayed 2nd intention healing when subcutaneous tissues were removed; wounds in dogs, but not cats, had largely recovered from this delay by 21 days.
Clinical Relevance— Extensive debridement of subcutaneous tissue may delay wound healing particularly in feline patients. A higher risk for wound infections may accompany extensive removal of subcutaneous tissues in dogs.  相似文献   

11.
OBJECTIVE: To determine whether povidone iodine ointment or 2 forms of silver sulfadiazine applied topically to wounds of the distal aspect of the limbs in horses affect the rate of second intention healing and to evaluate the additional influence of bandaging with these antimicrobials on granulation tissue formation. ANIMALS: 6 healthy adult horses. PROCEDURE: Six standardized 2.5-cm2 skin wounds/horse were distributed between the dorsomedial surfaces of the metacarpi and metatarsi. One of the following 6 treatments was applied to each wound: 1% silver sulfadiazine cream with bandage, 1% silver sulfadiazine slow-release matrix with bandage, 1% silver sulfadiazine slow-release matrix without bandage, povidone-iodine ointment with bandage, untreated control with bandage, and untreated control without bandage. Wound area, granulation tissue area, and perimeter were measured by use of planimetry software applied to digital images. Exuberant granulation tissue was excised when present. Days until healing, rate of healing parameter, rate of contraction, and epithelialization were compared among wound treatment groups. RESULTS: Healing parameters and mean days to healing did not differ significantly among any of the wound treatment groups. Percentage wound contraction and rate of epithelialization were similar among wound treatments. All bandaged wounds produced exuberant granulation tissue, which was surgically excised; none of the unbandaged wounds produced exuberant granulation tissue. CONCLUSIONS AND CLINICAL RELEVANCE: When exuberant granulation tissue is removed, rates of epithelialization and wound contraction were not different among wound treatment groups, whether bandaged or unbandaged. Topical application of 1% silver sulfadiazine slow-release matrix on unbandaged wounds induced the same result as medications applied beneath bandages, but without exuberant granulation tissue formation.  相似文献   

12.
Laser therapy is used in many countries, including South Africa, for the treatment of skin wounds. Low level galium aluminium arsenide (GaAlAs) laser was administered to full thickness skin wounds (3 x 3 cm) induced surgically on the dorsal aspect of the metacarpophalangeal joints of 6 crossbred horses in a randomised, blind, controlled study. Treated wounds that received a daily laser dosage of 2 J/cm2 were compared with nontreated control wounds on the opposite leg. There were no wound complications. Both groups of wounds were cleaned daily using tap water. Wound contraction and epithelialisation were evaluated using photoplanimetry. There were no significant differences in wound contraction or epithelialisation between the laser treated and the control wounds. It was therefore concluded that laser therapy had no clinically significant effect on second intention wound healing in this study.  相似文献   

13.
OBJECTIVE: To evaluate the effect of a commercially available 25% propylene glycol hydrogel preparation (Solugel; Johnson and Johnson Medical, North Ryde, Australia) on healing of full-thickness skin wounds on the distal aspect of the limb in horses. STUDY DESIGN: Experimental. ANIMALS: Eight Standardbred horses. METHODS: Standardized (2.5 x 2.5 cm) full-thickness skin wounds were created over the mid-dorsomedial aspect of both metacarpi in 8 horses. One wound in each horse was dressed with saline solution (0.9% NaCl) soaked gauze, and one was treated with Solugel under dry regular gauze; wounds were then bandaged with gauze-coated cotton wool and elastic adhesive bandages. Wounds were videorecorded and rebandaged twice weekly until healed. Wound healing variables were measured from the videorecordings using a computer software package and analyzed as a randomized complete block design with repeated measures. Where necessary variables were made positive for analysis; significance was set at P <.05. RESULTS: The area of the wound at the first bandage change did not vary between treated and untreated wounds. Treatment had no effect on the total rate of healing, rate of healing during the retraction phase of healing, rate of healing after the retraction phase was complete, or the amount the wounds retracted. CONCLUSIONS: Using this model of wound healing, Solugel had no effect on second intention healing of distal limb wounds in horses. CLINICAL RELEVANCE: Solugel does not appear to have any beneficial effect on healing of small full-thickness skin wounds to the distal limb of horses.  相似文献   

14.
Horses with severe and deep lacerations are represented by ten cases in which treatment emphasized the use of bovine collagen preparations to promote controlled second-degree repair. Traumatized areas were tarsal, metatarsal, neck, forearm, metacarpal and pastern. Wound size changes were recorded. Depending on the wound type, the site was treated with antibiotic-steroid ointment, organic acid cream, sterile collagen particles, suspension or dressings protected by hydrogel dressing, non-adherent pads, occlusive skin dressings, roll gauze and elastic tape. In three cases, a fiberglas cast was applied over a hind leg wound and lacerated tendon for stability. When controlled granulation of the deeper wounds reached skin level, the area often was stabilized by only cyanoacrylate spray. As these cases presented a wide range of trauma each with a unique history, healing rates were based on initial measurements. An overall progression of wound reduction occurred at a predictable rate. The exogenous collagen formulations were used to stimulate controlled granulation, ie. to “jump start” the healing process. Collagen particles, suspension or dressings were packed into depressions, placed under suture lines, secured over abraded tissue, and placed under protective bandage or cast. To further evaluate the use of cyanoacrylate tissue spray in wound treatments, an additional ten cases are presented. The variety of wounds were produced experimentally in Center-owned ponies or provided as clinical cases. Wound size changes and healing progress were recorded. Wounds occurred on the neck, abdomen, metacarpal, metatarsal, fetlock and pastern areas. Depending on wound type, the site was treated with cyanoacrylate only; or treated as above until controlled granulation attained skin level. In one case punch grafts of skin were transferred from one foreleg to the opposite with the horse standing. Cyanoacrylate spray provided a water proof barrier protecting the wound from dirt, debris and insects as well as stabilizing full-thickness skin lacerations by bridging normal to traumatized skin allowing uninterrupted granulation and epithelialization. The use of a neck cradle prevented wound disturbance and stall confinement aided stabilization.  相似文献   

15.
Objective : To assess whether wounds from incomplete mast cell tumour excisions are at greater risk of healing complications than wounds from complete excisions, or cutaneous histiocytomas. Methods : Mast cell tumours and cutaneous histiocytomas submitted to Nationwide Laboratories between November 1, 2007 and April 30, 2008 were selected. Questionnaires were sent to submitting veterinarians requesting details of tumour characteristics, clinical approach to the tumour and wound healing. Results : Three hundred and eighty‐six mast cell tumours and 524 cutaneous histiocytomas were identified. One hundred and eighty‐five mast cell tumours and 244 cutaneous histiocytomas questionnaires were returned (47% response). Wound complications arose in 20% of mast cell tumours and 21% of cutaneous histiocytomas. Multivariable analysis confirmed that larger tumours, tumours on the feet and a soft/“baggy” appearance, were significantly associated with a greater frequency of problems, leading to delayed wound healing and dehiscence. Clinical Significance : Incomplete mast cell tumour excision does not lead to greater risk of wound complications. Mast cell tumour surgical wounds have a similar rate of wound complications as cutaneous histiocytoma wounds.  相似文献   

16.
Second-intention healing of limb wounds in horses is often problematic. Solcoseryl is a protein-free, standardized dialysate/ultrafiltrate (HD) derived from calf blood, which has been shown to improve healing in both animals and humans. The efficacy of HD in the healing of deep wounds in horses and ponies was investigated. Deep wounds of 20 by 35 mm were created on both metatarsi (skin, subcutis, periosteum) and on both femoral biceps muscles (skin, subcutis, muscle) of five horses and five ponies. The wounds on one side were treated with HD, four times a week during the period that the wounds were bandaged and once daily thereafter. The wounds on the other side were left untreated. In the first 4 weeks of the healing period HD stimulated healing but inhibited healing thereafter. This pattern was significant for all wound groups (P < 0.001). Because of this change in effect, the overall effect on wound healing over the entire period was not significant (P = 0.77). HD stimulated healing initially by provoking a greater initial inflammatory response, faster contraction and faster formation of granulation tissue. Subsequently, HD inhibited healing because it significantly delayed epithelialization and caused protracted inflammation. The effects of HD were most pronounced in the horses. Because this study distinguished between contraction and epithelialization, it could be shown that HD stimulated contraction but inhibited epithelialization. Therefore, HD is useful in horses for the treatment of deep wounds during the initial phase of healing by second intention, i.e. during the first weeks when wound contraction can be expected. Treatment should be ceased when epithelialization becomes predominant.  相似文献   

17.
OBJECTIVE: To evaluate the effect of intramuscular administration of recombinant equine growth hormone on healing of full thickness skin wounds on equine limbs. STUDY DESIGN: Experimental. ANIMALS: Nine Standardbred horses. METHODS: In study 1, standardized full thickness skin wounds (2.5 x 2.5 cm) were made over the dorsomedial aspect of the mid-cannon bone of 1 forelimb and 1 hindlimb in 9 horses. Wounds were bandaged without treatment (control subjects) and videorecorded twice weekly until healed. Then, in study 2, similar wounds were created on the opposite limbs; 6 horses were administered intramuscular recombinant equine growth hormone (10 microg/kg daily for 7 days, then 20 microg/kg daily for 49 days), and 3 horses (control subjects) were administered equivalent volumes of sterile water. Wounds were videorecorded twice weekly until healed. Wound healing variables were measured from the videorecordings using a computer software package and analyzed as a randomized complete block design factorial analysis of variance; significance was set at P <.05. RESULTS: No differences in the measured variables were detected between wounds in study 1 and the control wounds in study 2. In recombinant equine growth hormone-treated horses, wounds retracted more during treatment and contracted faster after treatment stopped when compared with wounds from untreated horses. No other treatment effects were detected. CONCLUSIONS: Recombinant equine growth hormone seemingly increases wound retraction. After treatment ceases, wound contraction increases. CLINICAL RELEVANCE: Intramuscular administration of recombinant equine growth hormone (10 microg/kg daily for 7 days, then 20 microg/kg daily for 49 days) does not appear to have any beneficial clinical effect on healing of equine limb wounds.  相似文献   

18.
Recombinant human epidermal growth factor (rhEGF) stimulates the proliferation and migration of epithelial cells in human cell culture systems and animal models of partial-thickness skin wounds. This study investigated the effect of a topical rhEGF ointment on the rate of wound healing and skin re-epithelialization in a rat full thickness wound model, and verified whether or not the rhEGF treatment affected both myofibroblast proliferation and collagen synthesis in the dermis. When rhEGF (10 µg/g ointment) was applied topically twice a day for 14 days, there was significantly enhanced wound closure from the 5th to the 12th day compared with the control (ointment base treatment) group. A histological examination at the postoperative 7th day revealed that the rhEGF treatment increased the number of proliferating nuclear antigen immunoreactive cells in the epidermis layer. In addition, the immunoreactive area of alpha-smooth muscle actin and the expression of prolyl 4-hydroxylase were significantly higher than those of the control group. Overall, a topical treatment of rhEGF ointment promotes wound healing by increasing the rate of epidermal proliferation and accelerating the level of wound contraction related to myofibroblast proliferation and collagen deposition.  相似文献   

19.
Objective— To evaluate the effects of porcine small intestinal submucosa (PSIS) on the healing of full-thickness wounds in dogs, specifically the appearance of granulation tissue, percent epithelialization and contraction, histologic variables of inflammation and repair, and aerobic culture results.
Study Design— Prospective, controlled, experimental study.
Animals— Purpose-bred, female dogs (n=10).
Methods— Wounds were created bilaterally on the trunk; 1 side as a control and 1 treated with PSIS. First appearance of granulation tissue was recorded. Total wound area, open wound area, and epithelialized area were measured at 21 time points—wound contraction and percent epithelialization were calculated. Aerobic cultures were taken at 4 time points and wound biopsies at 8. Histologic features were graded into an Acute Inflammation Score and Repair Score.
Results— There was no difference in first appearance of granulation tissue between PSIS-treated and control wounds. Wound contraction was significantly faster in control wounds as was percent epithelialization after day 21. Histologic Acute Inflammation Scores were significantly higher in PSIS-treated wounds compared with control wounds on days 2 and 6. There were no differences in Histologic Repair Scores between PSIS-treated and control wounds or in aerobic culture results.
Conclusion— Wounds treated with PSIS contract more slowly, epithelialize less, and have more pronounced acute inflammation after implantation than control wounds.
Clinical Relevance— Acute, full-thickness wounds in dogs do not benefit from treatment with PSIS.  相似文献   

20.
Principles of wound healing   总被引：2，自引：0，他引：2  
Wound healing can be divided into immediate (zero to 1 hour), early (1 to 24 hours), intermediate (1 to 7 days), and late (greater than 7 days) stages. Many physical and physiologic events occur simultaneously and sequentially during these stages to produce the final wound scar. The processes of skin retraction, scab formation, would debridement, wound contraction, epithelial migration and proliferation, fibroplasia, and collagen maturation all must occur for healing to be successful. Many factors affect the size and shape of the resulting scar, including anatomic location and skin tension forces, systemic condition of the patient, blood supply to the wound, nutritional factors, environmental temperature, the presence of systemic drugs, wound infection, motion, wound oxygen gradient, wound moisture, and bandaging. Ideally, each of the factors would occur at a level compatible with optimal healing, but, in many clinical cases, one or more factors compromise normal, rapid healing. When we intervene with therapy, we probably adversely affect another factor in healing, while trying to correct the factor that is out of balance. In these decisions, the effects of our treatment on wound healing should be considered. The trade-off should be weighed and the treatment pursued only as long as necessary to allow healing to progress; then it should be discontinued or changed. With these considerations, it is hoped that we can attain healing at the most rapid physiologic rate.  相似文献   

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