烧伤创面外用生物敷料的研究现状

Progress in biomaterials for burn wound dressing

目的:介绍近年来烧伤创面外用生物敷料的新进展。资料来源:应用计算机检索中国期刊全文数据库2004-01/2007-03与生物敷料相关的文章,限定文章语种为中文,检索词:“生物敷料、烧伤创面敷料”;同时检索PUBMED2004-01/2007-03与烧伤创面外用生物敷料相关文献,检索词:“biomaterial,burn wound dressing”,限定语言种类为“English”。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与烧伤创面外用生物、合成敷料的研究相关,以近2年发表在较权威杂志者优先。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到188篇相关文献,排除132篇内容陈旧或重复的文献,56篇符合纳入标准。有52篇检索到全文,选用其中的30篇作为本文参考文献,10篇涉及胶原敷料在烧伤创面中的应用;12篇涉及甲壳素及其衍生物在烧伤创面中的应用;8篇涉及羊膜等在烧伤创面中的应用。资料综合:通过对大量烧伤患者创面治疗的对照研究结果证明,目前胶原敷料、甲壳素、羊膜等生物敷料疗效确切,具有临床使用价值和指导意义。但以上材料都有其缺点,胶原生物敷料稳定性较差和吸收渗液能力不强,其耐用性、生物相容性及制备的高成本限制了应用;羊膜质脆,用在关节区域创面易碎裂,不耐压,创面渗出多时易溶失。结论:生物敷料的发展非常迅速。但是,目前没有一种敷料能够达到理想敷料的要求。复合敷料由多层组成,每层具有不同的特点,也许是解决办法之一。

OBJECTIVE： To introduce the progress of biomaterials for bum wound dressing in recent years. DATA SOURCES： A computer-based online search of China Journal Full-text Database was undertaken to identify the articles about the biomaterials published from January 2004 to March 2007, with the retrieval words of ＂biomaterial, burn wound dressing＂, and language was limited to Chinese; Meanwhile the Pubmod database was retrieved for the related English articles about biomaterials for burn wound dressing published from January 2004 to March 2007, with the retrieval words of ＂biomaterial, burn wound dressing＂. STUDY SELECTION： All the data were checked primarily, and the citation of each literature was looked for. Inclusive criteria： the articles referring to the biological and synthetic dressing of burn wound, and those published in the authorized joumals in recent 2 years were preferred. Exclusive criteria： repeated researches or Meta analysis. DATA EXTRACTION： Totally 188 articles were chose, 132 of them were deleted due to the outdated or repeated contents, and 56 ones in accordance with the criteria were selected. There were 52 articles of intact texts and 30 of them were taken as the references of this study, 10 were about the application of collagen materials in burn wound dressing; 12 referred to the application of chitin and its dedvates in burn wound; and 8 were related to the application of amnion in burn wound. DATA SYNTHESIS： The control study of burn wound therapy based on a large sample of burnt patients shows that, the biomaterials, such as collagen dressing, chitin and amnion, are the current materials of burn wound and appear great applicative and instructive significances in clinic. However, they are all not perfect, collagen dressing is weak in stability and absorption ability, additionally its durability, biocompatibility and high cost also limit their application; chitin is easily fragile on the joint wound and dissolved when the wound leaks out. CONCLUSION： The biomaterials develop rapidly. However, there is no a kind of dressing material reaching the ideal standard. The composite dressing, consisting of many layers and each layer has it own merit, may be a suitable materials for burn wound dressing.