摘要：Objective The present study aims to explore the individualized treatment options for multisite pressure ulcer (PU) at various stages in elderly patients with multiple medical conditions. Methods Stages 1 and 2 PU at 146 sites were treated with closed negative pressure suction combined with continuous micro-oxygen perfusion and the local application of foam dressings, silver ion dressings, and moist burn cream. Stages 3 and 4 PU in the sacrococcygeal region were treated with skin or myocutaneous flap transplantation. Results Stages 1 and 2 PU healed after treatment with closed negative pressure suction combined with continuous micro-oxygen perfusion and dressing changes. One case died during hospitalization due to an illness. Skin or myocutaneous flap repair was conducted in 34 cases of stage 3 or 4 PU in the sacrococcygeal area. Of these cases, 28 achieved primary healing, and 6 required two or three surgeries, 5 of which received micro-skin implantation. In addition, 10 small deep PU at other sites were repaired by direct excision and suturing or local flap repair. Seven cases were transferred to other departments or hospitals due to concomitant diseases or were discharged automatically without surgical treatment. Conclusion Home care for geriatric patients is difficult. PU often occur at multiple sites because of the duration of various pressures, and different sites may demonstrate different stages because of varying degrees of pressure. When actively treating stages 3 and 4 PU, the trauma management of stages 1 and 2 PU should not be neglected.

摘要：Introduction and Aim of the Study: Scarring is a major concern in clinical dermatology, affecting individuals' quality of life due to both physical and psychological impacts. This review aims to explore the pathophysiology of various scar types—hypertrophic, keloid, and atrophic—and evaluate the effectiveness of current and emerging treatments to inform better clinical practices and therapeutic strategies. Description of the State of Knowledge: Scar formation involves complex biological processes: inflammation, proliferation, and remodeling. The nature of the scar varies with the underlying cause and biological response, influenced by genetic factors, skin tension, and environmental elements such as UV exposure. Recent advances in treatments range from surgical techniques to laser therapy and biological agents like cytokines. Conclusion: The studies reviewed underscore the complexity of scar management, influenced by diverse genetic, biological, and environmental factors. No single treatment is universally effective, but a combination of preventative and therapeutic strategies shows the best promise.

摘要：目的:观察皮肤再生医疗技术(Moist exposed burn therapy/Moist exposed burn ointment,MEBT/MEBO)促进糖尿病足Wagner 3级创面愈合作用,初步探讨MEBT/MEBO对糖尿病足Wagner 3级创面愈合过程中AGEs-RAGE信号通路的干预机制,为临床MEBT/MEBO治疗糖尿病足溃疡提供理论依据。方法:采用随机数字表法纳入50～70岁糖尿病足Wagner 3级患者进行随机分组,分为治疗组36例和对照组30例。两组病例均进行基础治疗,包括控制血压、血脂,扩血管、营养神经、营养支持等对症支持治疗。治疗组采用MEBT/MEBO进行创面处理,对照组采用贝复济进行创面处理,换药次数1～2次/日。在治疗前、治疗两周、治疗四周分别对患者创面情况及症状情况(包括渗液、腐肉、肉芽、上皮量、创面面积及深浅、周围皮色、肿胀、疼痛)进行记录,并依照症状积分量表进行比较。于治疗前、治疗两周、治疗四周分别取部分创面组织,匀浆取上清液采用ELASA法测定AGEs、RAGE表达水平。所有实验数据采用SPSS22.0统计分析软件处理,P<0.05为差异有统计学意义。结果:本研究共纳入66例糖尿病足Wagner 3级患者,分为治疗组(MEBO组)36例和对照组(贝复济组)30例。治疗前,两组病例一般情况(年龄、餐后血糖、肱踝指数、创面面积)、症状积分比较,组间差异均无统计学差异(P>0.05),具有可比性。治疗两周后,与贝复济组比较,MEBO组的腐肉、肉芽积分降低趋势明显,差异具有统计学意义(P<0.05);治疗四周后,MEBO组的渗液、腐肉、肉芽、上皮量、创面、创周情况积分较贝复济组下降趋势明显,差异具有统计学意义(P<0.05)。在治疗两周、治疗四周,两组创面组织AGEs表达水平均有所下降,与贝复济组比较,MEBO组AGEs表达量下降趋势明显,差异具有统计学意义(P<0.05);MEBO组在治疗两周、治疗四周RAGE表达量明显下降,与贝复济组比较,两组之间有明显统计学差异(P<0.05)。两组患者在经过四周治疗后,经秩和检验结果显示:治疗组痊愈2例,显效23例,有效9例,无效2例,有效率94.4%,显效率63.89%;贝复济组治愈0例,显效6例,有效19例,无效5例,有效率83.33%,显效率20%。两组结果比较,差异具有统计学意义(P<0.05),MEBO组疗效优于贝复济组。结论...

摘要：目的探讨湿润烧伤膏(MEBO)干预糖尿病性溃疡创面愈合的作用机制。方法将145只雄性健康SD大鼠随机分为空白组35只及糖尿病模型组110只,采用腹腔注射链脲佐菌素(STZ)制备糖尿病大鼠模型,8周后选空白组30只及糖尿病成模大鼠90只(模型组、MEBO组及贝复济组各30只),制备溃疡模型,成功后MEBO组予湿润烧伤膏纱条、贝复济组予重组牛碱性成纤维细胞生长因子溶液纱条、空白及模型组予生理盐水纱条局部换药处理,每日1次。给药后第3、6、12d,各组分别选10只大鼠,取相同位点创面组织,应用ELISA法检测组织匀浆中AGEs、NF-κB含量,荧光PCR技术检测组织中RAGE mRNA表达。结果与空白组比较,模型组大鼠第3、6、12d创面组织AGEs含量及RAGE mRNA表达量均显著升高(P<0.01),第3d创面组织NF-κB含量较低,第6d、12d含量持续升高(P<0.05或P<0.01)。与模型组比较,MEBO组第3、6、12d创面组织中AGEs含量及RAGE mRNA表达量均显著降低,贝复济组第3、6、12d组织中AGEs含量及第3d RAGE mRNA表达量显著下降,两组第3d创面组织中NF-κB含量均升高,第6、12d均明显下降,差异有显著性意义(P<0.05或P<0.01)。结论 MEBO促进糖尿病性溃疡创面愈合的机制与调控创面组织AGEs、NF-κB及RAGE mRNA的表达有关。