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期刊论文
A Controlled Randomized Trial Assessing Regenerative Therapy in Healing of Chronic Pressure Ulcers
Sakr, Mahmoud F.; Hamed, Hossam M.; Chong, Chen Y. Department of surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Department of surgery, Ahmadi Hospital, Kuwait oil Company (KOC), Ahmadi, Kuwait; Department of Burns, Wounds and Ulcers of Beijing Nanyuan Hospital, Beijing, China Journal of Surgery and Anesthesia 2019

摘要:Method: Consecutive patients (n=105) with CPUs (n=218) treated at three different hospitals were randomized to receive Moist Exposed Burn Ointment (MEBO) dressings (Regenerative group, n=55 with 115 ulcers) or wet-to-moist saline dressings (Control group, n=50 with 103 ulcers). Data collected prospectively included demographics, clinical, biochemical and ulcer features. Ulcer surface area (SA) and healing index (HI) were calculated and compared at twoweek intervals for 12 weeks. Results: Sixty-one patients (58.1%) were male and 44 (41.9%) were female. Their mean age was 69.5 years. There was an increase in HI and reduction in SA starting at two and four weeks, respectively in the regenerative group. At 12 weeks, 61.7% (71/115) of ulcers treated with MEBO had complete healing (HI=1) versus 28.2% (29/103) of controls (p=0.000). None of the patients receiving MEBO had a HI of<0.5 at 12 weeks as compared to 25.2% of controls (p=0.000). Significantly (p<0.01) more grade 2-4 ulcers healed completely with MEBO by 12 weeks. No adverse effects or allergic reactions were noted by 12 weeks. Conclusion: In addition to its safety, MEBO significantly promotes the healing of CPUs with significant increase in HI of any given ulcer as early as two weeks of treatment, and significant reduction of ulcer SA starting at four weeks with complete healing of more than 60% of ulcers by 12 weeks.

期刊论文
A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring
Sidgwick, G. P.; McGeorge, D.; Bayat, A. Plastic and Reconstructive Surgery Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester M1 7DN, UK; Grosvenor Nuffield Hospital, Wrexham Road, Chester CH4 7QP, England, UK Archives of Dermatological Research 2015

摘要:Wound healing after dermal injury is an imperfect process, inevitably leading to scar formation as the skin re-establishes its integrity. The resulting scars have different characteristics to normal skin, ranging from fine-line asymptomatic scars to problematic scarring including hypertrophic and keloid scars. Scars appear as a different colour to the surrounding skin and can be flat, stretched, depressed or raised, manifesting a range of symptoms including inflammation, erythema, dryness and pruritus, which can result in significant psychosocial impact on patients and their quality of life. In this paper, a comprehensive literature review coupled with an analysis of levels of evidence (LOE) for each published treatment type was conducted. Topical treatments identified include imiquimod, mitomycin C and plant extracts such as onion extract, green tea, Aloe vera, vitamin E and D, applied to healing wounds, mature scar tissue or fibrotic scars following revision surgery, or in combination with other more established treatments such as steroid injections and silicone. In total, 39 articles were included, involving 1703 patients. There was limited clinical evidence to support their efficacy; the majority of articles (n?=?23) were ranked as category 4 LOE, being of limited quality with individual flaws, including low patient numbers, poor randomisation, blinding, and short follow-up periods. As trials were performed in different settings, they were difficult to compare. In conclusion, there is an unmet clinical need for effective solutions to skin scarring, more robust long-term randomised trials and a consensus on a standardised treatment regime to address all aspects of scarring.

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