软组织的修复过程。酸度的影响

Alexander Alekseevich Andreev, A. Ostroushko, A. O. Chuyan, A. R. Karapityan
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引用次数: 2

摘要

由于创伤程度的增加,以及自然灾害和技术灾害突发事件数量的急剧增加,伤口处理成为现代外科最现实的问题之一。在美国,每年有超过3000万人被诊断出各种病因的软组织损伤。迄今为止,对于伤口愈合过程的病理生理学的理解已经有了深刻的理论基础,但是仍然有许多问题存在争议。再生过程的特点是高代谢活性和基于生化反应,其中pH值是非常重要的。伤口愈合过程中伤口pH值的变化在文章中有所反映。作者注意到pH对蛋白酶及其抑制剂活性、血管内皮生长因子(VEGF)表达、成纤维细胞活性、角质形成细胞增殖、微生物扩张以及伤口氧合的影响;为了应对微生物的入侵和传播。介绍了pH值对植皮存活影响程度的研究资料。综上所述,可以得出以下结论:pH在急性慢性伤口愈合中起调节作用;炎症期和增殖期前半期的酸性环境最有利于坏死松解和肉芽形成;炎症期后半期和上皮化期的碱性环境促进组织缺损的早期闭合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reparative Processes in Soft Tissues. Influence of Acidity
Wound treatment is one of the most actual problems of modern surgery due to the increase of degree of injury, and also due to a sharp increase in quantity of emergencies of natural and technogenic disasters. Injuries of soft tissues of various etiology are annually diagnosed in the USA more than for 30 million people. To date there is a deep theoretical base developed for understanding of a pathophysiology of wound healing process, however still many questions remain debatable. The regeneration process is characterized by high metabolic activity and is based on biochemical reactions for which the pH value is of great importance. Changes of pH values of a wound during wound healing process are reflected in article. The authors noted the influence of pH on proteases and its inhibitors activity, expression of vascular endothelial growth factor (VEGF), fibroblast activity, keratinocytes proliferation, microbial expansion, and also on wound oxygenation; in response to invasion and dissemination of microorganisms. Materials of the researches that determined pH influence degree on the skin graft survival are represented. Generalizing, following conclusions can be done: pH performs as a modulator in healing both acute chronic wounds; acidic milieu in the inflammation phase and the first half of the proliferation phase occurs to the most conducive, positively affecting on necrolysis and granulation formation; alkaline milieu in the second half of inflammation phase and in phase of epithelization  promotes early closing of the tissue defect.
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