شیوههای مختلف مدیریت زخم
محورهای موضوعی : زخم و عوارض آن ، شامل تولید، درمان جراحی، دارویی
ملیکا دانش
1
(دانش آموخته)
مهدی قمصری
2
(عضو هیئت علمی دانشگاه تهران)
فرج اله ادیب هاشمی
3
(عضو هیئت علمی دانشگاه تهران)
کلید واژه: پوست, زخم, التیام, مدیریت زخم,
چکیده مقاله :
پیوستگی پوست سالم نقش مهمی را در حفظ هموستاز طبیعی بدن ایفا میکند. مراقبت از زخم و پیشرفت روشهای التیام از مسائل مهم در علوم پزشکی به شمار میآید و همواره در حال پیشرفت است. با افزایش میزان بروز انواع زخمها و زخم های مزمنی که به درمان پاسخ نمیدهند و نیازمند مدت زمان طولانیتری برای التیام هستند مدیریت زخم پیچیدهتر گشته و از اهمیت بسزایی برخودار شده است. بنابراین همواره، نیاز روزافزونی به استفاده از بهترین روشهای درمانی برای بهبود التیام زخم وجود دارد. زخمهای پوستی به صورت خاص و کاهش مدت زمان التیام آنها یکی از جنبههای مهم در دامپزشکی هستند. در این مطالعه مروری به بررسی انواع روشهای مختلف قیزیکی و شیمیایی و بیولوژیک در درمان زخم پرداخته می شود.
The integrity of healthy skin plays a crucial role in maintaining physiological homeostasis of the body. Wound management is the most important issue in medicine and constantly evolving with the advances. The overall increase of different kind of wounds, and chronic wounds take a long time to heal makes wound care more complicated and important. Thus, there is a growing need to use of best methods for wound healing therapies to improve cutaneous wound healing. This article offers an overview of common methods of wound management, including physical, chemical and biological methods.
1. Richard B, William D, et al. Andrew’s diseases
of the skin. 10th ed. Philadelphia: W.B.
Saunders; 2005. p. 84-7.
2. Pazyar N, Yaghoobi R, Rafiee E, et al. Skin
wound healing and phytomedicine: a review.
Skin Pharmacol Physiol 2014; 27 (6): 303-310.
3. Kurach, Stanley, Gazzola, et al. The effect of
low-level laser therapy on the healing of open
wounds in dogs. Vet Surg 2015; 44 (8): 988-
996.
4. Ghamsari S. M, Taguchi K, Abe Net, al.
Histopathological effects of low-level laser
therapy on sutured wounds of the teat in
dairy cattle. Vet Q 1996; 18 (1).
5. Whinfield AL, Aitkenhead. The light revival:
does phototherapy promote wound healing?
A review. Foot (Edinb) 2009; 19 (2): 117-124.
6. Ohshiro T. Caldenhead R.G. Development of
low reactive-level laser therapy and its
present status. J Clin Las Med Sur 1991; 9 (4):
267-275.
7. Moshkovska T, Mayberry J. It is time to test
low level laser therapy in Great Britain. Postg
Med J 2005; 81 (957):436-441.
8. Farhapour M, Mavaddati A. Effects of borage
extract in rat skin wound healing model,
histopathological study. J Med Plants Res
2012; 6 (5): 651-656.
9. سید مهدی قمصری، امید مرادی. مروری بر مفاهیم و روش
های جدید التیام زخم. هشتمین سمپوزیوم جراحی و بی
هوشی و رادیولوژی دامپزشکی ایران، اسفند 88 ، تهران.
10. Jarahi M, Zahedi Khorasani M, et al.
Evaluation of topical matricaria chamomilla
oil extract activity on linear incisional wound
healing in albino rats. JMP 2008; 8 (29): 94-
99.
11. Rajasekaran S, K. Sivagnanam S, et al.
Antioxidant effect Aloe vera gel extract in
streptozotocin-induced diabetes in rats.
Pharmacol Rep 2005; 57: 90-96.
12. Baxter G, Bell A, Allen J, et al. Low level laser
therapy: current clinical practice in Northern
Ireland. Physiotherapy 1991; 77 (3): 171-178.
13. Mester E, Mester A.F, Mester A. The
biomedical effects of laser application. Las
sur Med 1985; 5 (1): 31-39.
14. Hawkins D, Abrahamse H. Effect of multiple
exposures of low level laser therapy on the
cellular responses of wounded human skin
fibroblasts. Photomed Laser Surg 2006; 24:
705-714.
Peplow PV, Chung TY, Baxter GD. Laser
photo biomodulation of proliferation of cells
in culture: a review of human and animal
studies. Photomed Laser Surg 2010; 28: S3-
40.
16. Jann HW, Bartels K, Ritchey JW, et al. Equine
wound healing: influence of low level laser
therapy on an equine metacarpal wound
healing model. Photon Laser Med 2012; 1:
117-122.
17. Stechmiller JK, Cowan L, et al. Nutrition
support for wound healing. Support Line
2009; 31: 2-8.
18. Ghamsari S, Taguchi K, Abe N, et al.
Histopathological effect of low level laser
therapy on sutured wounds of the teat in
dairy cattle. Vet Quar 1996; 18 (1): 17-21.
19. Ghamsari SM, Taguchi K, Abe N, et al.
Evaluation of wound healing of the teat with
and without low level laser therapy in dairy
cattle by laser Doppler flowmetry in
comparison with histopathology,
tensiometry and hyroxyproline analysis. Br
Vet J 1996; 152 (5): 583-592.
20 . دکتر عباس مجد آبادی. مبانی لیزر در پزشکی. انتشارات
. گسترش علوم پایه 1381
21 . ایرج نوروزیان، هستی آذرآباد، علی نصیریان، سید مهدی
قمصری. التیام زخم در دامهای بزرگ: هیستوپاتولوژی و
. مدیریت جراحی. انتشارات دانشگاه تهران، 1388
22. Bhatt J, Bhat A, Dhama, et al. An overview of
ozone therapy in equine: an emerging
healthcare solution. JEBAS 2016; 4: S203-
210.
23. César G, Duvaldo E, Ricardo R, et. Al. Skin
healing in one equine by therapy with ozone.
Brazil. Universidade Federal de Uberlândia,
Campus Umuarama. 2011.
24. Arnold M. Barbul, A. Nutrition and wound
healing. Plast Reconstr Surg 2006; 117 (7):
42-58.
25. Valacchi G, Lim Y, Belmonte G, et al.
Ozonated sesame oil enhances cutaneous
wound healing in SKH1 mice. Wound Repair
Regen 2011.
26. Markov MS, Colbert AP. Magnetic and
electromagnetic therapy, back
musculoskeletal. Rehabil 2001; 15: 17-29.
27. Foletti A, Lisi A, et.al, Cellular ELF signals as a
possible tool in informative medicine.
Electromagn Biol Med 2009; 28 (1):71-79.
28. Abdulrazaq A, Saberi Afshar F, Masoudifard
M, Effects the pulsed electromagnetic field
on the superficial digital flexor tendonitis in
donkey. Basra j vet res 2018; 17 (3).
29. Yung YL, Fu SC, Cheuk YC, et al. Optimisation
of platelet concentrates therapy:
Composition, localisation, and duration of
action. Asia Pac J Sports Med Arthrosc
Rehabil Technol 2017; 7: 27-36.
30. Reid B, Nuccitelli R, Zhao M. Non- invasive
measurement of bioelectric currents with a
vibrating probe. Nat Protoc 2007; 2: 661-
669.
31. Adams DS, Masi A, Levin M. H+ pumpdependent
changes in membrane voltage
are an early mechanism necessary and
sufficient to induce Xenopus tail
regeneration. Development 2007; 134: 1323-
1335.
32. Cho YW, Cho YN, Chung SH, et al. Watersoluble
chitin as a wound healing accelerator
biomaterials 1999; 20: 2139-2145.
33. Sun X, Jiang K, Chen J, et al. A systematic
review of maggot debridement therapy for
chronically infected wounds and ulcers. Int J
Infect Dis 2014; 25: 32-37.
34 . سید مهدی قمصری، محمد مهدی دهقان، علی رسولی، ایرج
نوروزیان. ارزیابی اثرات بالینی کیتین و کیتوسان بر التیام
زخمهای باز اندامهای حرکتی در اسب. مجله دانشکده
.)2( ، دامپزشکی دانشگاه تهرا . ن 1380 ، دوره 56
35. Roberts GAF. In: Chitin chemistry. London:
Macmillan Press; 1992. P. 7-20, 64.
36. Hayati F, Ghamsari S, Tavassoli A, et al. M.
Carbomer 940 hydrogel enhances capillary
blood flow and tissue viability in a skin burn
wound. IJVS 2016; 11 (1): 29-36.
37. Martin LF, Rocha EM, Garcia SB, et al. Topical
Brazilian propolis improves corneal woundhealing and inflammation in rats following
alkali burns. BMC Complement Altern Med.
2013; 27: 313-337.
38. Subrah M. A propective randomised clinical
and histology study of superficial burn
wound healing with honey and sulfadiazine.
Burn 1998; 224 (2): 157-161.
39. Crovetti G, Martinelli G, Issi M, Barone M, et
al. Platelet gel for healing cutaneous chronic
wounds. Transfus Apher Sci 2004; 30: 145-
151.
40. Nkao H, Yamazaki M, Ogawa H. Mixture of
sugar and povoidine stimulates wound
healing by activating keratinocytes and
fibroblast functions. Springer 2006; 298, 175-
182.
41. Gallagher J, Gray M. Is aloe vera effective for
healing chronic wounds? J Wound Ostomy
Continence Nurs 2003; 30 (2):68-71.
42. Glowania HJ, Raulin C, et al. The effect
Chamomile on wound healing-a controlled,
clinical, experimental double- blind trial. Z
Hautkr 1987; 62: 1262-1271.
43. Malekzadeh F. Antimicrobial activity of
Lawsonia inermis L. Appl Microbiol 1968; 16
(4):663-664.
44. Barceloux DG. Zinc. J Toxicol Clin Toxicol,
1999; 37:279-292
45. Zhao M. Electrical fields in wound healing-An
overriding signal that directs cell migration.
Sein Cell Dev Biol 2009; 20:674-682.
46. Kietzmann M, Braun M. Effects of the zinc
oxide and cod liver oil containing ointment
Zincojecol in an animal model of wound
healing. Dtsch Tierarztl Wochenschr 2006;
113: 331-334.
47. Agren MS, Ostenfeld U, et al. A randomized,
double-blind, placebo-controlled multicenter
trial evaluating topical zinc oxide for acute
open wounds following pilonidal disease
excision. Wound Repair Regen 2006; 14: 526-
535.
48. Berger MM, Binnert C, et al. Trace element
supplementation after major burns increases
burned skin trace element concentrations
and modulates local protein metabolism but
not whole-body substrate metabolism. Am J
Clin Nutr 2007; 85 (5): 1301-1306.
49. Golboe H, Ghaderi R. Wound healing. Journal
BUMS. 2012; 19 (3): 344-6.
50. Choudhary V, Choudhary M, Pandey S, et al.
Maggot debridement therapy as primary
tool to treat chronic wound of animals. Vet
World 2016; 9 (4): 403-409.
51. Andia I, Abate M. Platelet-rich plasma:
underlying biology and clinical correlates.
Regen Med 2013, 8: 645-658.
52. Rozman P, Bolta Z. Use of platelet growth
factors in treating wounds and soft-tissue
injuries. Acta Dermatovenerol Alp Panonica
Adriat 2007; 16: 156-165.
53. Kim JH, Park C, Park HM. Curative effect of
autologous platelet-rich plasma on a large
cutaneous lesion in a dog. Vet Dermatol
2009; 20: 123-126.
54. Krupski WC, Reilly LM, Perez S, et al. A
prospective randomized trial of autologous
platelet-derived wound healing factors for
treatment of chronic nonhealing wounds: a
preliminary report. J Vasc Surg 1991; 14:
526-532.
55. Anitua E, Andia I, Ardanza B, et al.
Autologous platelets as a source of proteins
for healing and tissue regeneration. Thromb
Haemost 2004; 91:4-15.
56. Everts PA. Autologous platelet-leukocyte
enriched gel basics and efficacy: a novel
method to support soft tissue and bone
healing PhD thesis. Eindhoven, Netherlands:
Catharina Hospital Eindhoven; 2007.
57. Moradi O, Ghamsari S, Dehghan M, et al.
Effects of platelet rich plasma (PRP) and
platelet rich growth factor (PRGF®) on the
wound healing of distal part of limbs in
horses. IJVS 2013; 08 (1): 41-48.
58. Nixon AJ. Preparation and application of
platelet-enriched plasma, in Proceeding XIV
Congress SIVE-FEEVA, Venice 2008; 332-339.