概念

創傷治癒阻害因子により創傷治癒機転が働きにくくなった状態

原因

局所的要因：低酸素、感染、壊死物質の残存、創面乾燥もしくは過剰な滲出液
漸進的要因：タンパク質・エネルギー低栄養状態(protein energy malnutrition; PEM)、微量元素不足、免疫不全状態、薬物、糖尿病、閉塞性血行障害、神経障害、悪性腫瘍、精神疾患

UpToDate Contents

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1. 慢性創傷の治療の概要overview of treatment of chronic wounds [show details]
… management of specific chronic wounds, including diabetic foot wounds, chronic orthopedic wounds, chronic abdominal wounds, pressure ulcers, ulcerated and fungating malignancy-related wounds, and venous ulcers …
2. 慢性創傷の臨床評価clinical assessment of chronic wounds [show details]
… should be considered "wounds in remission," because they are at very high risk for recurrence . The clinical assessment of chronic wounds, including differentiating the most common chronic ulcers, will be reviewed …
3. 創傷マネージメントの基本原則basic principles of wound management [show details]
…stimulate healing . On the other hand, the effect of chronic wound fluid on healing may not be beneficial. Chronic wound fluid is very different from acute wound fluid and contains persistently elevated levels …
4. 創傷の治癒遅延に関係する危険因子と合併症risk factors for impaired wound healing and wound complications [show details]
… alone can impair wound healing. When the healing process is stalled, a chronic wound may develop, and this is more likely to occur in patients with underlying medical disorders. Chronic ulceration commonly …
5. 創傷の治癒過程の基本原則basic principles of wound healing [show details]
…acute from a chronic wound. Chronic wounds are generally associated with physiologic derangements that impair the wound healing process. After hemostasis has been achieved, acute wounds normally heal …

Japanese Journal

多血小板血漿を用いた下肢難治性創傷治療

東田隆治
The Journal of Japanese Society of Limb Salvage and Podiatric Medicine 6(1), 49-55, 2014
… て得られる血小板を濃縮させた血漿に，血小板凝集反応を起こさせ，活性化させることにより放出された多量の成長因子を創傷治癒の促進に応用する方法である．糖尿病性足潰瘍や重症下肢虚血などの下肢慢性創傷では，肉芽内の成長因子やサイトカインなどがバランスを欠いた状態にあり，デブリードマン，血行再建，感染のコントロールを集学的治療で行った後，PRP gel を塗布することによりバランスのとれた肉芽 …
NAID 130003397876