糖尿病足创面敷料研究进展

Recent advances in wound dressings for diabetic foot

糖尿病足创面治疗是一个需要多学科参与的复杂临床课题，敷料在其中的作用不容忽视。理想的敷料应既能够保护伤口、减轻局部症状，又能够维持伤口湿润、促进创面愈合。任何一类敷料都不可能具有全部功能，但是每一种敷料都具有各自的特点。水凝胶敷料能促进组织自溶，在治疗坏死绀织较多的刨面时可与外科清创结合使用。藻酸盐和泡沫敷料具有良好的吸收性，适合于渗液量大的伤口．岔生长因子敷料和生物工程皮肤组织替代物在系统治疗3周以上仍难愈合的创面中疗效显著。感染性伤口应避免使用密闭性敷料，含抗生素的敷料可能有效。对于渗液较多的创面更换次数需要增加，避免周围组织浸渍。总之，敷料的选择应从创面的临床特点、患者自身的需求和成本效希等多方而考虑．

The managment of diabetic foot is a complicated clinical issue which involves many aspects,wound dressings play an important adjunctive role in the treatment of diabetic foot ulceration. Ideally, dressings should protect wound,alleviate symptoms,and maintain a moist wound environment,etc. No single dressing fulfills all the function,however,each category of dressings has particular characteristics that aid selection. Hydrogels facilitate autolysis and may be beneficial in managing ulcers with necrotic tissue. Foam and alginate dressings are highly absorbent and effective for heavily exuding wounds. The dressing containing growth factor or bioengineered tissue has been effectively and safely used to increase the incidence of complete wound closure. Occlusive dressings should be avoided for infected wounds, dressing impregnated with antibiotics or silver may be eligible for these wounds. In a word, decisions regarding which dressing to apply should be based on the characteristics of the ulcer, patient＇s preferences and cost effectiveness.