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。
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.
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.
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Study on Biological Mechanism of Vacuum Sealing Drainage in Clinical Application[J]. 临床医学进展, 2021, 11(02): 490-496. https://doi.org/10.12677/ACM.2021.112070
参考文献ReferencesFleischmann, W., Strecker, W., Bombelli, M., et al. (1993) Vacuum Sealing as Treatment of Soft Tissue Damage in Open Fractures. Unfallchirurg, 96, 488-492.徐海栋, 赵建宁, 卢俊浩, 等. 基于生物材料创面敷料封闭负压引流在创伤性骨髓炎治疗中的应用[J]. 中国组织工程研究, 2012, 16(12): 2189-2192.Nam, D., et al. (2018) The Use of Closed Incision Negative-Pressure Wound Therapy in Orthopaedic Surgery. The Journal of the American Academy of Orthopaedic Surgeons, 26, 295-302. <br>https://doi.org/10.5435/JAAOS-D-17-00054de Laat Erik, H.E.W., van den Boogaard Mark, H.W.A., Spauwen Paul, H.M., et al. (2011) Faster Wound Healing with Topical Negative Pressure Therapy in Difficult-to-Heal Wounds: A Prospective Randomized Controlled Trial. Annals of Plastic Surgery, 67, 626-631. <br>https://doi.org/10.1097/SAP.0b013e31820b3ac1Ceilley, G.H.R. (2017) Chronic Wound Healing: A Review of Current Management and Treatments. Advances in Therapy, 34, 599-610. <br>https://doi.org/10.1007/s12325-017-0478-yItano, N. and Kimata, K. (2010) Mammalian Hyaluronan Synthases. Iubmb Life, 54, 195-199.
<br>https://doi.org/10.1080/15216540214929Weindl, G., Schaller, M., SchÄFer-Korting, M., et al. (2004) Hyaluronic Acid in the Treatment and Prevention of Skin Diseases: Molecular Biological, Pharmaceutical and Clinical Aspects. Skin Pharmacology & Physiology, 17, 207-213.
<br>https://doi.org/10.1159/000080213赵京玉, 柴家科. 外源性透明质酸对创面愈合影响的研究进展[J]. 中华损伤与修复杂志(电子版), 2011, 6(1): 107-110.Taylor, K.R., Trowbridge, J.M., Rudisill, J.A., et al. (2004) Hyaluronan Fragments Stimulate Endothelial Recognition of Injury through TLR4. Journal of Biological Chemistry, 279, 17079-17084. <br>https://doi.org/10.1074/jbc.M310859200Shimizu, N., Ishida, D., Yamamoto, A., et al. (2014) Development of a Functional Wound Dressing Composed of Hyaluronic Acid Spongy Sheet Containing Bioactive Components: Evaluation of Wound Healing Potential in Animal Tests. Journal of Biomaterials Science, Polymer Edition, 25, 1278-1291.
<br>https://doi.org/10.1080/09205063.2014.929427Vasile, C., Pieptu, D., Dumitriu, R.P., et al. (2013) Chitosan/Hyaluronic Acid Polyelectrolyte Complex Hydrogels in the Management of Burn Wounds. Revista Medico Chirurgicala A Societatii De Medici Si Naturalisti Din Iasi, 117, 565-571.Iacopetti, I., Perazzi, A., Martinello, T., et al. (2020) Hyaluronic Acid, Manuka Honey and Acemannan Gel: Wound-Specific Applications for Skin Lesions. Research in Veterinary Science, 129, 82-89.
<br>https://doi.org/10.1016/j.rvsc.2020.01.009Lundin, A., Engström-Laurent, A., Hällgren, R., et al. (2010) Circulating Hyaluronate in Psoriasis. British Journal of Dermatology, 112, 663-671. <br>https://doi.org/10.1111/j.1365-2133.1985.tb02334.xCan, B.A., Muhtar, O.A., Haluk, Y., et al. (2015) Bio-Engineered Synovial Membrane to Prevent Tendon Adhesions in Rabbit Flexor Tendon Model. Journal of Biomedical Materials Research Part A, 103, 84-90.
<br>https://doi.org/10.1002/jbm.a.35151Shi, B., Sun, J.J., Cao, Y.L., et al. (2016) Application of Vacuum Sealing Drainage to the Treatment of Seawater-Immersed Blast-Injury Wounds. International Wound Journal, 13, 1198-1205. <br>https://doi.org/10.1111/iwj.12444Aruffo, A., et al. (1990) CD44 Is the Principal Cell Surface Receptor for Hyaluronate. Cell, 61, 1303-1313.
<br>https://doi.org/10.1016/0092-8674(90)90694-AChen, M., Yang, H.J., Wang, F., et al. (2019) Mycobacterium Intracellulare Vacuum Sealing Drainage: A Novel Treatment Method for Primary Cutaneous Infection. Indian Journal of Dermatology, Venereology and Leprology, 85, 605-608. <br>https://doi.org/10.4103/ijdvl.IJDVL_873_17杜伟斌, 傅杨纯, 王利祥, 等. 负压封闭引流技术在促进慢性创面愈合中的研究进展[J]. 中国医学创新, 2020, 17(20): 168-172.Delavary, B.M., Veer, W.M.V.D., Egmond, M.V., et al. (2011) Macrophages in Skin Injury and Repair. Immunobiology, 216, 753-762. <br>https://doi.org/10.1016/j.imbio.2011.01.001Mirza, R., Dipietro, L.A., Koh, T.J., Mirza, R., et al. (2009) Selective and Specific Macrophage Ablation Is Detrimental to Wound Healing in Mice. American Journal of Pathology, 175, 2454-2462.
<br>https://doi.org/10.2353/ajpath.2009.090248张婧. 巨噬细胞在皮肤伤口愈合过程中的调控作用及其机制研究[D]: [博士学位论文]. 西安: 西北大学, 2019.Weidenbusch, M. and Anders, H.J. (2012) Tissue Microenvironments Define and Get Reinforced by Macrophage Phenotypes in Homeostasis or during Inflammation, Repair and Fibrosis. Journal of Innate Immunity, 4, 463-477.
<br>https://doi.org/10.1159/000336717Gordon, S. (2003) Alternative Activation of Macrophages. Nature Reviews Immunology, 3, 23-35.
<br>https://doi.org/10.1038/nri978Rodero Mathieu, P., Legrand Julien, M.D., Bou-Gharios, G., et al. (2013) Wound-Associated Macrophages Control Collagen 1α2 Transcription during the Early Stages of Skin Wound Healing. Experimental Dermatology, 22, 143-145.
<br>https://doi.org/10.1111/exd.12068Phillips, P.G., Birnby, L.M. and Narendran, A. (1995) Hypoxia Induces Capillary Network Formation in Cultured Bovine Pulmonary Microvessel Endothelial Cells. American Journal of Physiology, 268, 789-800.
<br>https://doi.org/10.1152/ajplung.1995.268.5.L789王健. 巨噬细胞糖皮质激素受体信号在小鼠皮肤伤口修复中的调控作用[D]: [硕士学位论文]. 合肥: 安徽医科大学, 2016.Zhang, C.w., Liu, D.l., Liang, Z., et al. (2014) Repair of Refractory Wounds through Grafting of Artificial Dermis and Autologous Epidermis Aided by Vacuum-Assisted Closure. Aesthetic Plastic Surgery, 38, 727-732.
<br>https://doi.org/10.1007/s00266-014-0341-3Kim, P.J., Attinger, C.E., Constantine, T., et al. (2020) Negative Pressure Wound Therapy with Instillation: International Consensus Guidelines Update. International Wound Journal, 17, 174-186. <br>https://doi.org/10.1111/iwj.13254Borgquist, O., Ingemansson, R. and Malmsjö, M. (2010) Wound Edge Microvascular Blood Flow during Negative-Pressure Wound Therapy: Examining the Effects of Pressures from -10 to -175 mmHg. Plastic and Reconstructive Surgery, 125, 502-509. <br>https://doi.org/10.1097/PRS.0b013e3181c82e1f孟红阳, 杨新蕾, 张新合, 等. 负压封闭引流技术结合肌瓣转移游离植皮在面部难愈性创面修复中的应用[J]. 中国美容医学, 2019, 28(12): 22-26.Eo, S.R., Kim, Y.S. and Cho, S.H. (2011) Vacuum-Assisted Closure Improves the Incorporation of Artificial Dermis in Soft Tissue Defects: Terudermis and Pelnac. International Wound Journal, 8, 261-267.
<br>https://doi.org/10.1111/j.1742-481X.2011.00780.x徐又心. 负压封闭引流技术(VSD)在创面植皮中的应用[D]: [硕士学位论文]. 昆明: 昆明医科大学, 2016.Molnar, J.A., DeFranzo, A.J., Hadaegh, A., et al. (2004) Acceleration of Integra Incorporation in Complex Tissue Defects with Subatmospheric Pressure. Plastic and Reconstructive Surgery, 113, 1339-1346.
<br>https://doi.org/10.1097/01.PRS.0000112746.67050.68冯剑, 刘代宏. 负压引流技术对瘢痕切除复合植皮术患者创面细胞增殖活性及血管生成的影响[J]. 中国美容医学, 2017, 26(11): 34-37.Morykwas, M.J., et al. (2006) Vacuum-Assisted Closure: State of Basic Research and Physiologic Foundation. Plastic and Reconstructive Surgery, 117, 121S-126S. <br>https://doi.org/10.1097/01.prs.0000225450.12593.12周慧, 杨晓萍, 高玉镭, 等. 负压封闭引流技术(VSD)治疗糖尿病足溃疡[J]. 中国矫形外科杂志, 2019, 27(13): 1244-1245.赵斌, 褚庆玉, 安玉章, 等. 封闭式负压引流技术的临床应用进展[J]. 河北医药, 2020, 42(9): 1402-1407.Hu, C., et al. (2015) Study on the Effect of Vacuum Sealing Drainage on the Repair Process of Rabbit Sciatic Nerve Injury. International Journal of Neuroscience, 125, 855-860. <br>https://doi.org/10.3109/00207454.2014.979981