Granulation Tissue

肉芽组织
  • 文章类型: Systematic Review
    2021年,糖尿病影响了5.37亿成年人,总计花费了9,660亿美元的医疗保健费用。与糖尿病相关的最常见的并发症之一对应于糖尿病足溃疡(DFU)的发展。DFU影响约15%的糖尿病患者;这些溃疡由于神经病变而导致愈合受损,动脉疾病,感染,和异常的细胞外基质(ECM)降解,在其他因素中。本系统综述中讨论的生物活性玻璃基材料在加速糖尿病伤口愈合方面显示出有希望的结果。可以得出结论,就伤口愈合率和伤口愈合质量而言,添加BG是非常有价值的。因为BG激活成纤维细胞,增强M1到M2表型转换,诱导血管生成,并启动肉芽组织的形成和伤口的再上皮化。此外,观察到更高的密度和沉积以及更好的III型胶原组织。本系统综述是使用PRISMA指南进行的,旨在通过概述目前正在开发的材料及其在体外和体内糖尿病伤口愈合中的作用,为糖尿病伤口愈合治疗策略的发展做出贡献。
    Diabetes affected 537 million adults in 2021, costing a total of USD 966 billion dollars in healthcare. One of the most common complications associated with diabetes corresponds to the development of diabetic foot ulcers (DFUs). DFUs affect around 15% of diabetic patients; these ulcers have impaired healing due to neuropathy, arterial disease, infection, and aberrant extracellular matrix (ECM) degradation, among other factors. The bioactive-glass-based materials discussed in this systematic review show promising results in accelerating diabetic wound healing. It can be concluded that the addition of BG is extremely valuable with regard to the wound healing rate and wound healing quality, since BG activates fibroblasts, enhances M1-to-M2 phenotype switching, induces angiogenesis, and initiates the formation of granulation tissue and re-epithelization of the wound. In addition, a higher density and deposition and better organization of collagen type III are seen. This systematic review was made using the PRISMA guideline and intends to contribute to the advancement of diabetic wound healing therapeutic strategies development by providing an overview of the materials currently being developed and their effect in diabetic wound healing in vitro and in vivo.
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  • 文章类型: Journal Article
    背景:糖尿病是一种复杂的疾病,需要持续管理以控制血糖水平并预防并发症。糖尿病足溃疡(DFU)是糖尿病患者最常见的并发症。目前,在糖尿病足溃疡的治疗中具有相当大优势的流行治疗方式是负压伤口治疗(NPWT)。
    目的:本研究旨在回顾有关使用NPWT对DFU的疗效以及并发症或不良反应的相关文章。
    方法:从PubMed搜索英文数据库,Ebscohost,ProquestandScienceDirect旨在确定2017年1月至2022年1月之间发表的相关引文。“负压伤口治疗或NPWT”或“真空辅助闭合或VAC”和“糖尿病足溃疡或糖尿病足伤口”和“伤口愈合”和“常规敷料”和地图术语也用于主题标题。还回顾了参考书目中一些潜在的相关文章。
    结果:本研究包括8篇相关文章,由6篇RCT组成,1队列研究和1Quasy实验研究。在研究中,有各种使用NPWT和结果测量的方法学技术。本文献综述的结果表明,NPWT比其他常规或高级湿敷料更有效。该疗法显示了更快的愈合时间,伤口完全愈合,肉芽组织形成并减少了伤口大小。NPWT的并发症或不良反应,比如截肢率,出血和疼痛,与常规或高级湿敷料没有什么不同,不过。
    结论:NPWT对DFU的愈合比其他常规或高级湿敷料更有效。然而,使用该疗法的并发症或不良反应与其他常规或高级湿敷料没有显着差异。
    BACKGROUND: Diabetes mellitus is a complex disorder that requires continuous management to control blood sugar levels and prevent complications. Diabetic foot ulcers (DFU) are the most common complication in diabetic patients. A popular therapy modality with considerable advantages in the management of diabetic foot ulcers today is negative pressure wound therapy (NPWT).
    OBJECTIVE: This study aimed to review related articles about the efficacy as well as the complications or adverse effects of using NPWT on the healing of DFUs.
    METHODS: Searching English databases from PubMed, Ebscohost, Proquest and Science Direct was done to identify relevant citations published between January 2017 and January 2022. A combination of terms was used with the boolean formulation of \"negative pressure wound therapy OR NPWT\" OR \"vacuum-assisted closure or VAC\" AND \"diabetic foot ulcers OR diabetic foot wound\" AND \"wound healing\" AND \"Conventional dressings\" and map terms were also used for the subject heading. Some potentially relevant citations of articles from the bibliographies are also reviewed.
    RESULTS: This study included 8 related articles consisting of 6 RCTs, 1 cohort study and 1 Quasy experimental study. There were various methodological techniques for using NPWT and outcome measures among studies. The results of this literature review showed that NPWT was more efficacious than the other conventional or advanced moist dressings. This therapy revealed a faster healing time with complete wound healing and formation of granulation tissue and reduction in wound size. The complications or adverse effects of NPWT, such as amputation rate, bleeding and pain, were not different from conventional or advanced moist dressings, though.
    CONCLUSIONS: NPWT was more efficacious than other conventional or advanced moist dressings for the healing of DFUs. However, complications or adverse effects of using this therapy showed no significant difference with other conventional or advanced moist dressings.
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  • 文章类型: Journal Article
    目的:肉芽组织诱导的气管狭窄(主要继发于插管或肺移植)是良性气道阻塞的最常见病因之一。标准治疗选择(手术切除和/或支气管内介入)后的复发率可能会通过刺激更多的肉芽组织生成(通过增加成纤维细胞活性和增殖)而无意中恶化狭窄。低剂量放疗可能是一个有前途的工具,以防止肉芽组织形成后的手术和/或支气管内干预,因为它在瘢痕疙瘩或肥厚性瘢痕的治疗中确立的作用,两种病理生理学与气管狭窄相似的良性疾病。本研究回顾了使用支气管内近距离放射治疗(EBBT)或外束放射治疗(EBRT)治疗手术和/或支气管内干预后难治性肉芽组织引起的气管狭窄的病例报告和小系列。
    方法:病例报告和系列(截至2022年10月发布)报告了通过EBBT或EBRT(在确定性或预防性设置中)治疗的复发性肉芽组织诱导的气管狭窄(在手术和/或支气管内干预后)患者的结局。
    结果:16项研究(EBBT:9项研究,包括69名患者,EBRT:7项研究,包括32例患者)进行了回顾。EBBT和EBRT在所有研究中的合并成功率分别为74%和97%,分别。
    结论:放射治疗对某些复发性/难治性气管狭窄患者的治疗似乎是有效的。对这种治疗的反应通常很好,但需要对更多患者进行进一步研究和长期随访,以确定最佳技术,剂量,和放射治疗的时机,晚期并发症,响应的持久性,和患者选择标准。
    Granulation tissue-induced tracheal stenosis (mainly secondary to intubation or lung transplantation) is one of the most common etiologies of benign airway obstructions. Recurrence rates after standard treatment options (surgical resection and/or endobronchial interventions) can inadvertently worsen the stricture through the stimulation of more granulation tissue generation (via increased fibroblast activity and roliferation). Low-dose radiotherapy could be a promising tool to prevent granulation tissue formation after surgery and/or endobronchial interventions regarding its established role in the treatment of keloids or hypertrophic scars, two benign diseases with similar a pathophysiology to tracheal stenosis. This study reviews case reports and small series that used endobronchial brachytherapy (EBBT) or external beam radiotherapy (EBRT) for the management of refractory granulation tissue-induced tracheal stenosis after surgery and/or endobronchial interventions.
    Case reports and series (published up to October 2022) that reported outcomes of patients with recurrent granulation tissue-induced tracheal stenosis (after surgery and/or endobronchial interventions) treated by EBBT or EBRT (in definitive or prophylactic settings) were eligible.
    Sixteen studies (EBBT: nine studies including 69 patients, EBRT: seven studies including 32 patients) were reviewed. The pooled success rate across all studies was 74% and 97% for EBBT and EBRT, respectively.
    Radiation therapy appears to be effective in the management of selected patients with recurrent/refractory tracheal stenosis. Response to this treatment is usually good, but further studies with a larger number of patients and long-term followup are necessary to determine the optimal technique, dose, and timing of radiation therapy, late complications, the durability of response, and criteria for patient selection.
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  • 文章类型: Review
    本报告描述了1型糖尿病患儿在鼻道外使用耳用环丙沙星/地塞米松滴剂后高血糖的新观察结果,并回顾了以往关于儿科患者鼻内皮质类固醇激素不良内分泌作用的报道。
    我们描述了临床病例,并对MEDLINE(PubMed)和EMBASE进行了文献综述。
    一名9个月大的女性,有1型糖尿病病史,接受单侧后鼻孔闭锁修复术,接受环丙沙星0.3%/地塞米松0.1%耳滴1周,每天两次治疗后鼻孔阻塞和肉芽组织。虽然患者的气道通畅性得到改善,在患者的连续血糖监测仪上发现平均每日血糖增加40至50分。高血糖在改用0.05%糠酸莫米松喷雾剂后2天内消退。我们还回顾了21例小儿耳鼻咽喉科的医源性库欣综合征病例,这些病例与在气道中使用局部类固醇悬浮液的标签上和标签外使用相关。患者的年龄范围为3个月至16岁,使用的剂量为50μg/天至2mg/天。
    这是第一例报道的与鼻内类固醇混悬液相关的血糖水平升高的儿科病例。据我们所知.在为婴儿和幼儿处方超标签使用这些药物时,就精确剂量给药和潜在的内分泌紊乱为家庭提供咨询至关重要。特别是患有潜在内分泌紊乱的患者,如糖尿病。
    UNASSIGNED: This report describes a new observation of hyperglycemia in a child with Type 1 diabetes after off-label use of otic ciprofloxacin/dexamethasone drops in the nasal passage and reviews previous reports of adverse endocrine effects from intranasal corticosteroids in pediatric patients.
    UNASSIGNED: We describe the clinical case and conducted a literature review of MEDLINE (PubMed) and EMBASE.
    UNASSIGNED: A 9-month-old female with a history of Type 1 diabetes who underwent unilateral choanal atresia repair was started on 1 week of ciprofloxacin 0.3%/dexamethasone 0.1% otic drops twice a day for choanal obstruction with granulation tissue. While the patient\'s airway patency improved, average daily blood glucose increases by 40 to 50 points were noted on the patient\'s continuous glucose monitor. The hyperglycemia resolved within 2 days after switching to mometasone furoate 0.05% spray. We also review 21 pediatric otolaryngology cases of iatrogenic Cushing\'s syndrome associated with on- and off-label use of topical steroid suspensions in the airway. Patients ranged from 3 months to 16 years in age and used doses of 50 μg/day to 2 mg/day.
    UNASSIGNED: This is the first reported pediatric case of increased blood glucose levels associated with intranasal steroid suspensions, to the best of our knowledge. Counseling families on precise dose administration and potential endocrine disturbances is critical when prescribing these medications for off-label use in infants and small children, particularly among patients with underlying endocrine disorders such as diabetes.
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  • 文章类型: Case Reports
    背景:输尿管肉芽组织血管瘤是罕见的良性血管病变,它们可能在临床上无症状或存在大量或复发性血尿。有时血管瘤很难与恶性输尿管肿瘤区分开来,大多数输尿管血管瘤经术后病理检查证实。本文旨在介绍一例输尿管肉芽组织型血管瘤,并简要回顾有关这种情况的现有文献。
    方法:一名30岁男性患者主诉无痛性肉眼血尿2个月。泌尿系统计算机断层扫描显示右输尿管上1/3被占据,然后考虑肿瘤病变的可能性。尿液细胞学检查显示偶尔有细胞核异常,尿液中有许多浅色晶体。由于可疑的放射学和细胞学发现,患者接受了右输尿管镜检查和腹腔镜右输尿管肿块切除术。术后病理报告显示为间叶性肿瘤。形态学和免疫组织化学染色与血管瘤一致,倾向于肉芽组织血管瘤。手术后,患者状态良好,末次随访时恢复良好.
    结论:输尿管肉芽组织血管瘤是一种易误诊的疾病。间歇性无痛性血尿是本病的重要特征。因此,我们建议,当临床医生在评估过程中考虑到良性输尿管肿瘤的可能性时,可以避免不必要的根治性手术。
    BACKGROUND: Ureteral granulation tissue hemangiomas are rare benign vascular lesions, and they may be clinically asymptomatic or present with massive or recurrent hematuria. Sometimes hemangiomas are difficult to distinguish from malignant ureteral tumors, and most ureteral hemangiomas are confirmed by postoperative pathological examination. This article aims to present a case of granulation tissue-type hemangioma of the ureter and briefly review the current literature on this condition.
    METHODS: A 30-year-old male patient presented with complaints of painless macroscopic hematuria for 2 months. Computerized tomography of the urinary system showed that the upper 1/3 of the right ureter was occupied, and then the possibility of tumor lesions was considered. The urine cytology showed occasional nuclear abnormalities and many light-stained crystals in urine. Because of suspicious radiological and cytological findings, the patient underwent the right ureteroscopy and the laparoscopic right ureteral mass resection. The postoperative pathological report showed that it was a mesenchymal tumor. The morphological and immunohistochemical staining was consistent with that of hemangioma, tending to granulation tissue hemangioma. After surgery, the patient was in a good state and recovered well at the last follow-up.
    CONCLUSIONS: Ureteral granulation tissue hemangiomas are an easily misdiagnosed disease. Intermittent painless hematuria is an important characteristic of this disease. Therefore, we suggest that unnecessary radical surgery can be avoided when clinicians consider the possibility of benign ureteral tumors during the evaluation.
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    文章类型: Journal Article
    慢性不愈合的伤口对患者健康和医疗保健系统构成严重关切。在全身性合并症和患者不依从性的背景下,慢性伤口的管理变得尤其具有挑战性。
    作者评估了专有的自适应自组装屏障支架(aSABS)在复杂慢性伤口的管理和愈合中的性能。
    6名具有解剖学和病因学上不同的慢性伤口的患者被考虑使用aSABS治疗,这是在有执照的医疗保健专业人员的监督下处方使用。伤口对各种治疗方案无反应持续8周至20多年。自适应自组装屏障支架每周应用于临床,除了1例每2周应用一次。不需要机构审查委员会的批准,因为aSABS的使用符合美国食品和药物管理局批准的使用适应症。
    只有3到6次应用aSABS后,这些伤口在愈合方面表现出显著的改善,伴随着炎症和感染的抑制,肉芽组织形成,和上皮再生。自适应自组装屏障支架还促进了积极的清创术,以去除发炎,感染,和坏死组织,提供有效的伤口管理和出血控制,同时充当保护屏障。此外,aSABS的使用减轻了患者和护理人员在家中进行伤口护理的负担。此外,这种aSABS的使用可能为临床医生提供高敏锐度手术室的替代方案,因为它有助于在低敏锐度门诊诊所环境中清创和处理一些复杂的伤口-这是COVID-19大流行期间特别重要的产品属性,有助于确保及时有效的治疗.
    在这项研究中,SABS显示临床利益在短时间内的患者有显著的合并症和不愈合的伤口。aSABS的使用可以通过在低敏锐度门诊诊所环境中促进清创和处理一些复杂伤口,为临床医生提供高敏锐度手术室的替代方案。这些结果可用于为使用aSABS作为伤口护理开始时的治疗的中心方面以及作为先前的标准和高级治疗方案不成功的伤口的救援产品提供令人信服的论据。
    Chronic nonhealing wounds pose a serious concern for patient health and the health care system. Management of chronic wounds becomes especially challenging in the setting of systemic comorbidities and patient nonadherence.
    Authors evaluated the performance of a proprietary adaptive self-assembling barrier scaffold (aSABS) in the management and healing of complex chronic wounds.
    Six patients with anatomically and etiologically diverse chronic wounds were considered for treatment with aSABS, which is for prescription use under the supervision of a licensed health care professional. The wounds had been unresponsive to various treatment regimens for 8 weeks to more than 20 years. The adaptive self-assembling barrier scaffold was applied in the clinic weekly, with the exception of 1 case in which it was applied every 2 weeks. Institutional Review Board approval was not required because use of aSABS was in accordance with the US Food and Drug Administration-cleared indications for use.
    After only 3 to 6 applications of aSABS, these wounds showed notable improvement in healing, accompanied by suppression of both inflammation and infection, granulation tissue formation, and reepithelialization. The adaptive self-assembling barrier scaffold also facilitated aggressive debridement to remove inflamed, infected, and necrotic tissues, providing effective wound management and bleeding control while functioning as a protective barrier. Furthermore, use of aSABS reduced the at-home burden of wound care for patients and caretakers. Additionally, use of this aSABS may offer clinicians an alternative to high acuity operating rooms by facilitating debridement and management of some complex wounds in a low acuity outpatient clinic setting-a particularly crucial product attribute during the COVID-19 pandemic that helped ensure timely and effective treatment.
    In this study, aSABS demonstrated clinical benefit in a short period of time in patients with significant comorbidities and nonhealing wounds. Use of aSABS may offer clinicians an alternative to high-acuity operating rooms by facilitating debridement and management of some complex wounds in a low-acuity outpatient clinic setting. These outcomes can be used to make a compelling argument for use of aSABS as a central aspect of treatment at the onset of wound care and as a rescue product for wounds for which prior standard and advanced treatment protocols were unsuccessful.
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  • 文章类型: Journal Article
    在马的第二意向伤口愈合期间,经常观察到旺盛的肉芽组织(EGT)。尽管它对伤口护理有影响,导致EGT的基本机制尚不清楚,缺乏预防和/或治疗EGT的有效策略.EGT的发展知之甚少,涉及成纤维细胞过度增殖和角质形成细胞功能失调分化的多因素过程,次优的伤口收缩,血管功能失调,慢性炎症。巩固和描述关于EGT的基础和临床研究文献,并确定知识差距和未来研究的机会,使用预定义的搜索词系统地进行了搜索.随后,使用特定标准进行范围审查,以选择描述治疗和/或预防EGT方法的同行评审文献.提出的作用机制以及结果和主要结论进行了提取和列表。系统搜索在PubMed中产生了1062种出版物,在WebofScience中产生了767种出版物。后来纳入了20项其他研究。其中,对327项研究进行了基础研究的叙述性审查,对35项对照临床试验进行了范围审查。所有35项研究都是在大学医院进行的,除一个外,其他都涉及手术诱导的未感染伤口。研究人群主要是马(n=230),小马(n=18)和驴(n=14)。总之,仍然非常需要关于EGT治疗的循证建议,最好使用代表马的普通人群的多中心研究,包括更多的动物,并在自然发生的伤口中进行。此叙述和范围审查还强调了在临床试验的研究设计中纳入基础研究知识的重要性。
    Exuberant granulation tissue (EGT) is often observed during second intention wound healing in horses. Despite its impact on wound care, the basic mechanisms leading to EGT are still unclear and effective strategies to prevent and/or treat EGT are lacking. The development of EGT is a poorly understood, multifactorial process involving hyperproliferating fibroblasts and malfunctional differentiation of keratinocytes, suboptimal wound contraction, dysfunctional vascularisation, and chronic inflammation. To consolidate and describe basic and clinical research literature on EGT and to identify knowledge gaps and opportunities for future research, a search was systematically conducted using predefined search terms. Subsequently, a scoping review was conducted using specific criteria to select the peer-reviewed literature that described methods to treat and/or prevent EGT. Proposed mechanisms of effects as well as results and main conclusions were extracted and tabulated. The systematic search resulted in 1062 publications in PubMed and 767 in Web of Science. Twenty additional studies were later included. Of these, 327 studies were reviewed for the narrative review on basic research and 35 controlled clinical trials were eligible for the scoping review. All 35 studies were conducted in university hospitals, and all but one involved surgically induced non-infected wounds. The study population was predominantly horses (n = 230) with a small number of ponies (n = 18) and donkeys (n = 14). In conclusion, there remains a strong need for evidence-based recommendations on EGT treatment, preferably using multi-centre studies that represent the general population of horses, include higher numbers of animals, and are performed in naturally occurring wounds. This narrative and scoping review also emphasises the importance of incorporating basic research knowledge in the study design of clinical trials.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    It is estimated that 2% of the population in developing countries suffer from a chronic wound, making it a hidden phenomenon that is increasing as populations age. The ease of access to maggot therapy has made it increasingly attractive for implementation. This study aimed to explore the effectiveness of maggot therapy as compared to hydrogel dressings in the healing of chronic wounds.
    An electronic literature search until October 2019 was performed using Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature. The eligibility criteria were chronic wound patients with an intervention that involved a comparison of any maggot species with hydrogel dressings.
    The full text of five studies, involving 580 patients with chronic wounds, was retrieved. Four studies used the Lucilia sericata species. The maggot therapy facilitated faster and more effective debridement of non-viable tissue. It enabled faster development of granulation tissue and increased reduction in the wound surface area compared to hydrogel dressings. Maggot therapy had no effect on disinfection or complete healing rate for the wound.
    Maggot therapy should be considered for faster wound debridement, granulation tissue development, and wound surface area reduction as well as in surgical contraindications. This review can be used as a guide to assist clinicians in identifying patients who may benefit from maggot therapy.
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