Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. Th...Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed;these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.展开更多
目的构建并验证下肢静脉溃疡(venous leg ulcer,VLU)延迟愈合风险预测模型,为早期识别延迟愈合高风险人群提供借鉴。方法采用便利抽样方法,选取2018年1月—2022年12月在四川省2所三级甲等医院血管外科就诊的331例VLU患者作为建模组,选取...目的构建并验证下肢静脉溃疡(venous leg ulcer,VLU)延迟愈合风险预测模型,为早期识别延迟愈合高风险人群提供借鉴。方法采用便利抽样方法,选取2018年1月—2022年12月在四川省2所三级甲等医院血管外科就诊的331例VLU患者作为建模组,选取另1所三级甲等医院收治的112例患者作为验证组。采用单因素分析、最小绝对值收敛和选择算子回归、多因素Logistic回归分析筛选VLU延迟愈合的危险因素,使用R软件构建预测模型,采用受试者操作特征曲线下面积、Hosmer-Lemeshow检验及临床决策曲线综合评价模型的预测性能,并分别进行Bootstrap重抽样内部验证和空间外部验证。结果最终纳入模型的预测变量为糖尿病(OR=4.752)、下肢深静脉血栓(OR=4.104)、皮肤脂质硬化(OR=5.405)、溃疡复发(OR=3.239)、踝关节活动(OR=5.520)。该模型具有较好的区分度(受试者操作特征曲线下面积:内部验证为0.819,外部验证为0.858)、校准度(Hosmer-Lemeshow检验:内部验证χ^(2)=13.517,P=0.095;外部验证χ^(2)=3.375,P=0.909)和临床有效性。结论该研究构建的VLU延迟愈合风险预测模型具有较好的区分度和校准度,可以有效预测VLU延迟愈合高风险人群,有利于临床采取针对性干预措施改善溃疡结局,降低溃疡延迟愈合风险。展开更多
文摘Biofilm is the predominant mode of life for bacteria and today it is implicated in numerous human diseases. A growing body of scientific and clinical evidence now exists regarding the presence of biofilm in wounds. This review summarizes the clinical experiences and in vivo evidence that implicate biofilm in delayed wound healing. The various mechanisms by which biofilm may impede healing are highlighted, including impaired epithelialization and granulation tissue formation, and reduced susceptibilities to antimicrobial agents and host defenses. Strategies to manage biofilm and encourage progression to wound healing are discussed;these include debridement and appropriate antimicrobial therapies which may be improved upon in the future with the emergence of anti-biofilm technologies.
文摘目的构建并验证下肢静脉溃疡(venous leg ulcer,VLU)延迟愈合风险预测模型,为早期识别延迟愈合高风险人群提供借鉴。方法采用便利抽样方法,选取2018年1月—2022年12月在四川省2所三级甲等医院血管外科就诊的331例VLU患者作为建模组,选取另1所三级甲等医院收治的112例患者作为验证组。采用单因素分析、最小绝对值收敛和选择算子回归、多因素Logistic回归分析筛选VLU延迟愈合的危险因素,使用R软件构建预测模型,采用受试者操作特征曲线下面积、Hosmer-Lemeshow检验及临床决策曲线综合评价模型的预测性能,并分别进行Bootstrap重抽样内部验证和空间外部验证。结果最终纳入模型的预测变量为糖尿病(OR=4.752)、下肢深静脉血栓(OR=4.104)、皮肤脂质硬化(OR=5.405)、溃疡复发(OR=3.239)、踝关节活动(OR=5.520)。该模型具有较好的区分度(受试者操作特征曲线下面积:内部验证为0.819,外部验证为0.858)、校准度(Hosmer-Lemeshow检验:内部验证χ^(2)=13.517,P=0.095;外部验证χ^(2)=3.375,P=0.909)和临床有效性。结论该研究构建的VLU延迟愈合风险预测模型具有较好的区分度和校准度,可以有效预测VLU延迟愈合高风险人群,有利于临床采取针对性干预措施改善溃疡结局,降低溃疡延迟愈合风险。
