凝胶敷料用于骨外露创面的修复:创新与发展

摘要

BACKGROUND: Bone exposed wounds are frequently required to deal with in orthopaedic surgeries, involving the treatment of open fractures, bone tumors, osteomyelitis, and many other diseases, in which the defect of soft tissue caused by open fractures is the most difficult to deal with. Conventional debridement or negative pressure closed drainage technology is difficult to make bone exposed wounds heal, and the process is extremely cumbersome, during which,patients suffer a lot of pain.OBJECTIVE: To evaluate the advantages and disadvantages of the various types of dressings, and review the application of new hydrogel dressing in bone exposed wounds based on its advantages, such as keeping wound environment moisture, restoring skin physical barrier, contributing to routine dressing change.METHODS: A computer-based online retrieval of PubMed and CNKI databases was performed to search papers published between 2000 and 2016 using the key words "hydrogel dressing, bone exposed wound, traditional wound dressing, antibiotic" in English and Chinese, respectively. A total of 55 papers suitable for final analysis from the application of traditional and new dressings in bone tissue engineering were reviewed.RESULTS AND CONCLUSION: The treatment of bone exposed wounds involves the treatment of many diseases, such as open fractures, bone tumors, osteomyelitis, which is still an orthopedic problem to solve. The novel hydrogel dressings with unique advantages are able to provide better plans for bone exposed wounds, and the use of these dressings solves the regeneration and repair of exposed bone, and improves the infection of antibiosis. In addition, the gel dressings currently have become a hot spot of research because of the characteristics of sustained-release.%背景:骨外露创面是骨科临床常需要处理的问题,涉及到开放性骨折、骨肿瘤、骨髓炎等诸多疾病的治疗,其中尤其以开放性骨折所致的软组织缺损骨外露的处理最为困难.常规的清创换药或负压封闭引流技术很难使骨外露创面获得愈合,且过程繁琐,给患者造成痛苦.目的:评价各种类型的敷料的优缺点,并从新型水凝胶敷料所具有的使创面环境保持水分湿润、恢复皮肤的物理屏障、有利于日常敷料更换等优点对其在骨外露创面中的在骨组织应用进行综述.方法:以英文检索词为"hydrogel dressing,bone exposure wound,traditional wound dressing,antibiotic"及中文检索词为"骨外露创面,水凝胶敷料,传统创面敷料,生长因子",由第一作者检索2000至2016年PubMed数据库及中国知网中文科技数据库,查阅近年相关文献,最终保留53篇文献,从中对传统敷料与新型敷料在骨组织工程中的应用进行综述.结果与结论:骨外露创面的治疗由于其涉及到开放性骨折、骨肿瘤、骨髓炎等诸多疾病的治疗,仍然是是骨科临床亟需处理的问题.目前,新型水凝胶敷料所具有的各项独特的优点,能够为骨外露创面的患者提供更加完善的治疗方案,解决了骨外露创面的再生修复,抗菌感染等相关的问题,另外,凝胶敷料所具有的稳定的药物缓释的特性,使得载药水凝胶敷料成为目前的研究热点之一.