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摘要: 氧气在创面愈合过程中起着至关重要的作用。研究表明,超过97%的慢性创面处于缺氧状态,这是导致创面迁延不愈的关键因素之一。局部氧疗是一种不依赖受损的脉管系统直接向创面供氧的治疗方式,即通过特定的装置或制剂将充足的氧气传输到创面,有效促进慢性创面愈合。血红蛋白喷剂是局部氧疗的一种新形式,具有效果良好、操作简单及成本低等优势。该文就血红蛋白喷剂的发展、组成成分、安全性、供氧原理、使用方法以及在慢性创面治疗中的作用进行综述,为慢性创面治疗提供新方向。Abstract: Oxygen plays an important role in the process of wound healing. Researches have shown that more than 97% of chronic wounds are in a state of hypoxia, which is one of the key factors resulting in refractory wounds. Local oxygen therapy is a treatment method that can directly provide oxygen to wounds without relying on the damaged vascular system. It can effectively promote chronic wounds healing by transmitting sufficient oxygen to wounds through specific devices or preparations. Hemoglobin spray is a new form of local oxygen therapy, which has the advantages of good effect, simple operation, and low cost. This article reviews the development, component, safety, oxygen supply principle, and application methods of hemoglobin spray and its effects in the treatment of chronic wounds, so as to provide a new direction for the treatment of chronic wounds.
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Key words:
- Hemoglobins /
- Spray /
- Chronic wound /
- Local oxygen therapy
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[1] KathawalaMH,NgWL,LiuD,et al.Healing of chronic wounds: an update of recent developments and future possibilities[J].Tissue Eng Part B Rev,2019,25(5):429-444.DOI: 10.1089/ten.TEB.2019.0019. [2] 谭谦,徐晔.慢性创面治疗的理论和策略[J].中华烧伤杂志,2020,36(9):798-802.DOI: 10.3760/cma.j.cn501120-20200728-00361. [3] YounisI.Role of oxygen in wound healing[J].J Wound Care,2020,29(Sup5b):S4-10.DOI: 10.12968/jowc.2020.29.Sup5b.S4. [4] GurtnerGC,WernerS,BarrandonY,et al.Wound repair and regeneration[J].Nature,2008,453(7193):314-321.DOI: 10.1038/nature07039. [5] CopelandK, PurvisAR. A retrospective chart review of chronic wound patients treated with topical oxygen therapy[J]. Adv Wound Care (New Rochelle), 2017,6(5):143-152.DOI: 10.1089/wound.2017.0729. [6] ArenbergerP,EngelsP,ArenbergerovaM,et al.Clinical results of the application of a hemoglobin spray to promote healing of chronic wounds[J].GMS Krankenhhyg Interdiszip,2011,6(1):Doc05.DOI: 10.3205/dgkh000162. [7] HammelHT.Oxygen transport through hemoglobin solutions. AMRL-TR-66-19[J]. AMRL TR, 1966:1-18. [8] Barnikol WKR, TeslenkoA, Pötzschke H. A new topic treatment of chronic wounds with haemoglobin and oxygen: procedure and first results[J]. Zeitschrift fur Wundheilung, 2005, 10(3):98-108. [9] KnutK, GaborG, BenjaminJ. Assessment of acceptability and ease of use of haemoglobin spray (granulox®) in the management of chronic wounds [J]. Chronic Wound Care Management and Research, 2020, 7:1-10. DOI: 10.2147/CWCMR.S212108. [10] BatemanSD.Use of topical haemoglobin on sloughy wounds in the community setting[J].Br J Community Nurs,2015,Suppl Wound Care:S32, S34-39.DOI: 10.12968/bjcn.2015.20.Sup9.S32. [11] HolzerJC,BirngruberT,MautnerS,et al.Topical application of haemoglobin: a safety study[J].J Wound Care,2019,28(3):148-153.DOI: 10.12968/jowc.2019.28.3.148. [12] SavlaC,MunozC,HickeyR,et al.Purification of lumbricus terrestris mega-hemoglobin for diverse oxygen therapeutic applications[J].ACS Biomater Sci Eng,2020,6(9):4957-4968.DOI: 10.1021/acsbiomaterials.0c01146. [13] LiuH,YanC,YanK,et al.Study of the effects of polymerized porcine hemoglobin (pPolyHb) in an acute anemia rat model[J].Artif Cells Nanomed Biotechnol,2017,45(4):694-700.DOI: 10.1080/21691401.2016.1228665. [14] GauthierTW,GrunwellJR,PingXD,et al.Impaired defenses of neonatal mouse alveolar macrophage with cftr deletion are modulated by glutathione and TGFβ1[J].Physiol Rep,2017,5(6):e13086.DOI: 10.14814/phy2.13086. [15] García-de-la-AsunciónJ,García-Del-OlmoE,GalanG,et al.Glutathione oxidation correlates with one-lung ventilation time and PO2/FiO2 ratio during pulmonary lobectomy[J].Redox Rep,2016,21(5):219-226.DOI: 10.1080/13510002.2015.1101890. [16] HewittNJ, TroutmanJ, PrzibillaJ,et al. Use of in vitro metabolism and biokinetics assays to refine predicted in vivo and in vitro internal exposure to the cosmetic ingredient, phenoxyethanol, for use in risk assessment[J].Regul Toxicol Pharmacol, 2022,131:105132. DOI: 10.1016/j.yrtph.2022.105132. [17] EisenbudDE.Oxygen in wound healing: nutrient, antibiotic, signaling molecule, and therapeutic agent[J].Clin Plast Surg,2012,39(3):293-310.DOI: 10.1016/j.cps.2012.05.001. [18] SchremlS,SzeimiesRM,PrantlL,et al.Oxygen in acute and chronic wound healing[J].Br J Dermatol,2010,163(2):257-268.DOI: 10.1111/j.1365-2133.2010.09804.x. [19] GellDA.Structure and function of haemoglobins[J].Blood Cells Mol Dis,2018,70:13-42.DOI: 10.1016/j.bcmd.2017.10.006. [20] PetriM,StoffelsI,GriewankK,et al.Oxygenation status in chronic leg ulcer after topical hemoglobin application may act as a surrogate marker to find the best treatment strategy and to avoid ineffective conservative long-term therapy[J].Mol Imaging Biol,2018,20(1):124-130.DOI: 10.1007/s11307-017-1103-9. [21] HaycocksS,McCardleJ,FindlowAH,et al.Evaluating the effect of a haemoglobin spray on size reduction in chronic DFUs[J].Br J Nurs,2016,25(6 Suppl):S54-62.DOI: 10.12968/bjon.2016.25.6.S54. [22] JonkerL, SmithD, MarkE,et al. A pragmatic, single-center, prospective, randomized controlled trial of adjunct hemoglobin-mediated granulox topical oxygen therapy twice weekly for foot ulcers[J]. J Am Podiatr Med Assoc, 2021,111(5). DOI: 10.7547/19-189. [23] ChadwickP, McCardleJ, MohamudL, et al.Appropriate use of topical haemoglobin in chronic wound management: consensus recommendations[J]. The Diabetic Foot Journal, 2015,18:142-146. [24] DissemondJ,KrögerK,StorckM,et al.Topical oxygen wound therapies for chronic wounds: a review[J].J Wound Care,2015,24(2):53-54, 56-60, 62-63.DOI: 10.12968/jowc.2015.24.2.53. [25] PetriM,StoffelsI,JoseJ,et al.Photoacoustic imaging of real-time oxygen changes in chronic leg ulcers after topical application of a haemoglobin spray: a pilot study[J].J Wound Care,2016,25(2):87, 89-91.DOI: 10.12968/jowc.2016.25.2.87. [26] 姚泽欣,付小兵,程飚.慢性创面愈合新理念:姑息性创面治疗的研究进展[J].中华烧伤杂志,2020,36(8):754-757.DOI: 10.3760/cma.j.cn501120-20190929-00388. [27] HuntSD. Topical oxygen-haemoglobin use on sloughy wounds: positive patient outcomes and the promotion of self-care[J]. Wounds UK, 2015,11(4):90-95. [28] DunnillC,PattonT,BrennanJ,et al.Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process[J].Int Wound J,2017,14(1):89-96.DOI: 10.1111/iwj.12557. [29] HuntSD,ElgF.Clinical effectiveness of hemoglobin spray (Granulox®) as adjunctive therapy in the treatment of chronic diabetic foot ulcers[J].Diabet Foot Ankle,2016,7:33101.DOI: 10.3402/dfa.v7.33101. [30] WeiX, LiM, ZhengZ, et al. Senescence in chronic wounds and potential targeted therapies[J/OL]. Burns Trauma, 2022,17(10):tkab045[2022-08-31]. https://pubmed.ncbi.nlm.nih.gov/35187179/. DOI: 10.1093/burnst/tkab045. [31] BatemanSD.Topical haemoglobin spray for diabetic foot ulceration[J].Br J Nurs,2015,24(12):S24-29.DOI: 10.12968/bjon.2015.24.Sup12.S24. [32] HuntS,ElgF.The clinical effectiveness of haemoglobin spray as adjunctive therapy in the treatment of chronic wounds[J].J Wound Care,2017,26(9):558-568.DOI: 10.12968/jowc.2017.26.9.558. [33] HuntSD,ElgF,PercivalSL.Assessment of clinical effectiveness of haemoglobin spray as adjunctive therapy in the treatment of sloughy wounds[J].J Wound Care,2018,27(4):210-219.DOI: 10.12968/jowc.2018.27.4.210. [34] WinaikosolK,PunyavongP,JenwitheesukK,et al.Radiation ulcer treatment with hyperbaric oxygen therapy and haemoglobin spray: case report and literature review[J].J Wound Care,2020,29(8):452-456.DOI: 10.12968/jowc.2020.29.8.452. [35] SnydersPCS, KleintjesWG, CronjeUJ, et al. The use of haemoglobin spray (Granulox) in a complicated burns patient[J]. South African Journal of Plastic & Reconstructive Aesthetic Surgery & Burns, 2021, 3(3): 62. [36] Babadagi-HardtZ,EngelsP,KanyaS.Wound management with compression therapy and topical hemoglobin solution in a patient with Budd-Chiari Syndrome[J].J Dermatol Case Rep,2014,8(1):20-23.DOI: 10.3315/jdcr.2014.1165. [37] BastendorfKD,Strafela-BastendorfN,LussiA.Mechanical removal of the biofilm: is the curette still the gold standard?[J].Monogr Oral Sci,2021,29:105-118.DOI: 10.1159/000510187. [38] SnelgroveH,BaileffA.A review of interventions to reduce pain in chronic wounds[J].Br J Community Nurs,2019,24(Sup12):S12-17.DOI: 10.12968/bjcn.2019.24.Sup12.S12. [39] PaschouSA,StamouM,VuagnatH,et al.Pain management of chronic wounds: diabetic ulcers and beyond[J].Maturitas,2018,117:17-21.DOI: 10.1016/j.maturitas.2018.08.013. [40] 朱小妹,李旭英,刘华云,等.湿性愈合理念在急性放射性皮肤损伤患者中的疗效观察[J].护士进修杂志,2019,34(16):1515-1518.DOI: 10.16821/j.cnki.hsjx.2019.16.021. [41] TickleJ,BatemanSD.Use of a topical haemoglobin spray for oxygenating pressure ulcers: healing outcomes[J].Br J Community Nurs,2015,20 Suppl 12:S14-21.DOI: 10.12968/bjcn.2015.20.Sup12.S14. [42] GottrupF,DissemondJ,BainesC,et al.Use of oxygen therapies in wound healing[J].J Wound Care,2017,26(Sup5):S1-43.DOI: 10.12968/jowc.2017.26.Sup5.S1. [43] MustafiN,EngelsP.Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series[J].J Wound Care,2016,25(4):191-192, 194-198.DOI: 10.12968/jowc.2016.25.4.191. [44] HuntSD. Self-care in the self-harm population: positive patient outcomes utilising innovative topical haemoglobin therapy[J].Wounds UK,2016,12(3):76-82. [45] BrüeggenjürgenB, EberleinT, HuntS. Wound management in diabetic foot ulcer (DFU)-incremental cost-analysis of treating diabetic neuropathic foot lesions with adjunct hemoglobin contact spray in Germany[J]. Value in Health, 2017, 20(9): A582. DOI: 10.1016/j.jval.2017.08.1040.
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