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Commentary on A multinational, multicenter, randomized, double-blinded, placebo-controlled trial to evaluate the efficacy of cyclical topical wound oxygen therapy (TWO2) in the treatment of chronic diabetic foot ulcers: The TWO2 study 一项多国、多中心、随机、双盲、安慰剂对照试验,旨在评估周期性伤口局部氧疗(TWO2)治疗慢性糖尿病足溃疡的疗效:TWO2研究
Pub Date : 2019-01-01 DOI: 10.15761/mri.1000165
R. Frykberg
Topical Oxygen therapy (TOT) in various forms has been used for the treatment of chronic wounds for over fifty years [1-6 ]. Its effectiveness has been disputed despite many positive clinical and animal reports attesting to its benefits towards promoting wound healing. Various delivery mechanisms have been utilized in this regard including continuous delivery of oxygen (CDO) under low or very low Oxygen tensions or Cyclical Pressurized topical delivery generally within a localized extremity chamber. Hyperbaric Oxygen Therapy (HBOT) proponents have long criticized the ability of TOT to have a meaningful effect on wound repair in the absence of systemic delivery of Oxygen [7]. Despite the many inconsistent wound healing clinical studies of HBOT itself [8-13], most criticisms of TOT, notwithstanding the skepticism mentioned above, are due to an extremely limited number of robust high-quality investigations. We therefore performed a study to assess the efficacy of multi-modality cyclical pressure Topical Wound Oxygen (TWO2) homecare therapy in healing refractory diabetic foot ulcers (DFU) that had failed to heal with standard of care (SOC) alone [14].
各种形式的局部氧疗(TOT)用于慢性伤口的治疗已有50多年的历史[1-6]。它的有效性一直存在争议,尽管许多积极的临床和动物报告证明它有利于促进伤口愈合。在这方面使用了各种输送机制,包括在低或极低氧张力下连续输送氧气(CDO)或通常在局部肢体腔内循环加压局部输送。高压氧疗法(HBOT)的支持者长期以来一直批评TOT在缺乏全身氧气输送的情况下对伤口修复有意义的影响。尽管HBOT本身的许多伤口愈合临床研究不一致[8-13],但对TOT的大多数批评,尽管上面提到的怀疑,都是由于数量极其有限的可靠的高质量调查。因此,我们进行了一项研究,以评估多模式周期性压力局部伤口氧(TWO2)家庭护理治疗在单独标准护理(SOC)无法愈合的难治性糖尿病足溃疡(DFU)中的疗效。
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引用次数: 5
Healing comparison of porcine cutaneous incisions made with cold steel scalpel, standard electrosurgical blade, and a novel tissue dissector. 冷钢手术刀、标准电刀和新型组织解剖刀对猪皮肤切口愈合的比较。
Pub Date : 2017-10-01 Epub Date: 2017-10-27 DOI: 10.15761/MRI.1000124
Albert Y Wu, Thomas J Baldwin, Bhupendra C Patel, Jeffrey W Clymer, Ryan D Lewis

Background: Standard electrosurgery provides superior hemostasis compared to a cold steel scalpel, but inferior tissue healing. A novel electrosurgical blade with an advanced waveform, the MEGADYNE ACE BLADE™ 700 Soft Tissue Dissector (ACE), was designed to provide both excellent hemostasis and wound healing. This study compared ACE to scalpel and standard electrosurgery in a porcine model of wound healing.

Methods: Skin incisions from six pigs were evaluated at time points of 0, 1, 2, 3 and 6 weeks after application of the three devices. Histopathology was performed on samples from each time point. For each non-initial time point, the healing incisions were photographed for later evaluation by expert graders, and excised for wound strength testing.

Results: Time 0 photomicrographs showed a gradient of thermal tissue damage by initial incision, ranging from no damage made by the scalpel, minimal damage made by ACE, and twice the ACE damage made by a nonstick PTFE-coated electrosurgical blade. Histopathologic analysis at 6 weeks showed comparable dermal scar width measurements for scalpel and ACE incisions. Scars were wider for incisions made by standard electrosurgical blade. Wound strength was greater for scalpel and ACE than for standard electrosurgery. Cosmetic results at 6 weeks were not significantly different between scalpel and ACE incisions, while standard electrosurgical blade incisions were significantly inferior to ACE (odds ratio: 53.4, p<0.001).

Conclusion: The MEGADYNE ACE BLADE™ 700 Soft Tissue Dissector represents a significant improvement in electrosurgical technology for skin incisions and dispels the traditional concerns of delayed healing and poor cosmetic result that have been attributed to using conventional electrosurgical blades for skin incisions.

背景:与冷钢手术刀相比,标准电手术止血效果更好,但组织愈合效果较差。MEGADYNE ACE blade™700软组织解剖刀(ACE)是一种具有先进波形的新型电刀,旨在提供出色的止血和伤口愈合。本研究比较了ACE与手术刀和标准电手术在猪伤口愈合模型中的应用。方法:分别在使用三种器械后0、1、2、3和6周的时间点对6头猪的皮肤切口进行评估。对每个时间点的样本进行组织病理学检查。对于每个非初始时间点,对愈合切口进行拍照,供专家评分者稍后评估,并切除进行伤口强度测试。结果:Time 0显微照片显示初始切口对热组织的损伤有梯度,从手术刀无损伤到ACE损伤最小,到不粘ptfe涂层电刀对ACE损伤的两倍。6周的组织病理学分析显示,手术刀切口和ACE切口的皮肤疤痕宽度测量值相当。标准电刀切口的疤痕较宽。手术刀和ACE的伤口强度大于标准电手术。手术刀切口与ACE切口6周美容效果无显著差异,而标准电刀切口明显低于ACE切口(优势比:53.4,p)。MEGADYNE ACE BLADE™700软组织解剖器代表了皮肤切口电刀技术的重大改进,消除了传统电刀治疗皮肤切口所带来的延迟愈合和美容效果差的担忧。
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引用次数: 3
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Medical research and innovations
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