創傷治癒:参考文献


 創傷治療,消毒に関する参考文献を挙げます。なお,インターネットで検索できたものに関しては,Abstractも掲載しておきます。無料のインターネット文献検索サービスはこちらへ


創傷治癒全般,およびドレッシングについての総合的な書籍



消毒薬は創傷治癒を阻害

  1. Dilute povidone-iodine solutions inhibit human skin fibroblast growth.
    • Author : Balin AK, Pratt L.
    • Magazine : Dermatol Surg 2002 Mar;28(3):210-4
    • Abstract :
      BACKGROUND: Povidone-iodine solutions are widely used and highly effective antiseptics. Although commonly used at full strength, this concentration appears to be toxic to the cells involved in wound healing. Few systematic studies of povidone-iodine toxicity have been reported. The effects of various dilutions of 10% povidone-iodine solution on the growth of human diploid fibroblasts were assessed using in vitro cell culture.
      OBJECTIVE: The purpose of this study was to systematically evaluate the toxicity of povidone-iodine on living cells using an in vitro model.
      METHODS: Adult skin fibroblasts and fetal lung fibroblasts were subcultivated at various seeding densities of 3000-10,000 cells/cm2 and grown in polystyrene tissue culture flasks under an atmosphere containing 5% O2, 5% CO2, and 90% N2. Cells were grown in a medium containing various concentrations of povidone-iodine (1%, 0.1%, 0.025%, 0.01%, and 0%). Cell attachment was reduced by 0.1% and 1% povidone-iodine in our initial studies; subsequent experiments were performed by changing the medium to contain the povidone-iodine 24 hours after seeding. Growth curves were performed by counting triplicate cultures every 48 hours for 250-300 hours.
      RESULTS: Fibroblast growth was progressively retarded at 0.01% and 0.025%, and totally inhibited by 0.1% and 1% povidone-iodine solutions. Partial recovery of cell growth after limited exposure of cultures to dilute solutions of povidone-iodine was noted.
      CONCLUSION: This study shows that even dilute solutions of povidone-iodine are toxic to human fibroblasts. The results indicate that caution should be used when povidone-iodine is placed on an open wound, and that prolonged contact with viable uncontaminated tissue should be avoided.


  2. In Vitro and in vivo studies of local disinfection and wound healing.
    • Author : Hagedorn M, Hauptmann S, et al.
    • Magazine : Hautarzt 1995 May; 46(5): 319-24


  3. Effect of povidone-iodine on wound healing: a review
    • Author : Kramer, SA.
    • Magazine : J. Vasc. Nurs. 1999 Mar; 17(1):17-23


  4. The effects of chlorhexidine digluconate on human fibroblasts in vitoro.
    • Author : Pucher, JJ. and Daniel, JC
    • Magazine : J. Periodontal 1992, Jun; 63(6): 526-32



消毒薬と生理食塩水の比較

  1. A comparison of wound irrigation solutions used in the emergency department
    • Author : Dire, DJ. and Welsh, AP.
    • Magazine : Ann Emerg Med 1990 Jun;19(6):704-8


  2. Wound cleaning versus wound disinfection: a challenging dilemma.
    • Author : Phillips, D. and Davey, C.
    • Magazine : Perspectives 1997 winter;21(4):15-6



脳外科手術でも剃毛は必要ない

  1. 脳神経外科手術患者の無剃毛に関するエビデンスとケアの実際

  2. The effect of hair on infection after cranial surgery.



水道水による傷の洗浄に関するもの

  1. Wound irrigation in children: saline solution or tap water?

  2. Water for wound cleansing.

  3. Can tap water be used to irrigate wounds in A&E?

  4. Evidence-based practice: tap water cleansing of leg ulcers in the community.

  5. Wound irrigation with tap water.

  6. Comparison of normal saline with tap water for wound irrigation.

  7. Tap water as a wound cleansing agent in accident and emergency.

  8. Comparison between sterile saline and tap water for the cleaning of acute traumatic soft tissue wounds.



洗浄の方法,洗浄の圧力について

  1. Syringe pressure irrigation of subdermic tissue after appendectomy to decrease the incidence of postoperative wound infection
    • Author : Cervantes-Sanchez CR, et et.
    • Magazine : World J. Surg., 2000 Jan; 24(1): 38-41, duscussion 41-2


  2. Low-versus high-pressure irrigation techniques in Staphylococcus aureus-inoculated wounds
    • Author : Pronchik, D. et al.
    • Magazine : Am J Emerg Med, 1999 Mar; 17(2): 121-4



インシュリン注射の際,皮膚の消毒は不要

  1. Is skin preparation ncessary before insulin injection ?
    • Author : Veikko A. Koivisto et al.
    • Magazine : The Lancet,May20,1978 1072-1073


  2. The safety of injecting insulin through clothing
    • Author : Doris R. Fleming et al
    • Magazine : Diabetes Care,volume20,Number3,March 1997,244-247



術前の手洗いでブラシ洗いは必要か?

  1. Hand-Rubbing With an Aqueous Alcoholic Solution vs Traditional Surgical Hand-Scrubbing and 30-Day Surgical Site Infection Rates


アルギン酸塩被覆材の止血能力,および体内に遺残させた場合の変化

  1. Comparison of absorbable materials for surgical haemostasis.



痛くない局所麻酔の打ち方

  1. Buffered versus plain lidocaine for digital nerve blocks.
    • Author: Bartfield JM, Ford DT, Homer PJ.
    • Magazine: Ann Emerg Med 1993 Feb;22(2):216-9
    • Abstract:
      STUDY OBJECTIVES: To test whether buffered lidocaine is less painful to administer as a digital nerve block than plain lidocaine.
      DESIGN: Randomized, double-blind, prospective clinical trial. SETTING: University hospital emergency department.
      PARTICIPANTS: Adults not allergic to lidocaine requiring a digital nerve block.
      INTERVENTIONS: Subjects received digital nerve blocks by injection of buffered lidocaine on one side and plain lidocaine on the other in a predetermined, randomized order. Pain of infiltration was assessed. Scores were compared using a two-tailed t-test. Standard 1% lidocaine was used if additional anesthetic was required.
      MEASUREMENTS AND MAIN RESULTS: Thirty-one patients were enrolled. Buffered lidocaine was significantly less painful to administer than plain lidocaine (P < .001; t = 4.21). Supplemental anesthesia was required less often for buffered lidocaine (two times) compared with plain lidocaine (six times), although this difference was not statistically significant.
      CONCLUSION: Because it causes less pain and is equally efficacious, buffered lidocaine is preferable to plain lidocaine for digital nerve blocks in adults.


  2. Buffered lidocaine as a local anesthetic: an investigation of shelf life.
    • Author: Bartfield JM, Homer PJ, Ford DT, Sternklar P.
    • Magazine: Ann Emerg Med 1992 Jan;21(1):16-9
    • Abstract:
      STUDY OBJECTIVE: To determine whether buffered lidocaine must be prepared just before use.
      DESIGN: Randomized, double-blind, prospective trial.
      SETTING: University hospital. PARTICIPANTS: Twenty-four adult volunteers.
      INTERVENTIONS: Three buffered lidocaine solutions prepared seven days, one day, and just before use were compared with a control solution. Subjects received 0.5 mL intradermal injections of each solution. Pain of infiltration and extent and duration of anesthesia were measured.
      MEASUREMENTS AND MAIN RESULTS: Pain of infiltration was less with all buffered solutions than control (P less than .0001). Mean maximum diameter of anesthesia ranged from 29 to 33 mm for the buffered solutions compared with 31 mm for control. Mean duration of anesthesia was 33 minutes for control and 30 minutes for all of the buffered solutions. There was no statistically significant difference in extent or duration of anesthesia for any of the solutions (P greater than .5, beta = .15 for delta = 10%).
      CONCLUSION: Buffered lidocaine stays effective for up to one week after preparation. It is therefore convenient to use in emergency settings.


  3. Pain of local anesthetics: rate of administration and buffering.
    • Author: Scarfone RJ, Jasani M, Gracely EJ.
    • Magazine: Ann Emerg Med 1998 Jan;31(1):36-40
    • Abstract:
      STUDY OBJECTIVE: To determine the impact of administration rate and buffering on the pain associated with subcutaneous infiltration of lidocaine.
      METHODS: Forty-two adult volunteers employed at a tertiary care center participated in this prospective, single-blinded study. Each subject received four lidocaine injections prepared and administered as follows: slow, buffered (SB); slow, unbuffered (SU); rapid, buffered (RB); rapid, unbuffered (RU). Buffering was accomplished by mixing 1% lidocaine with 8.4% sodium bicarbonate in a 9:1 ratio. Slow administration was 30 seconds and rapid was 5 seconds. Needle size (27-gauge), injection depth (.25 inch), lidocaine volume (1.0 mL), and temperature (room) were the same for each of the four injections. In all four conditions, the needle remained in the forearm for 30 seconds, to ensure blinding. The main outcome measure was the mean pain score for each condition, as recorded on a 10-cm visual analog scale.
      RESULTS: The lowest pain scores (mean +/- SE) were recorded for the SU and SB conditions at 1.49 +/- 29 and 1.48 +/- 26, respectively, and they were significantly lower than the scores for RB (2.34 +/- 28; P < .01) or RU (3.11 +/- 33; P < .001). Each of the slow conditions was reported to be the "least painful" of the four significantly more often than either rapid condition.
      CONCLUSION: This is the largest blinded study to assess administration rate and the pain of a local anesthetic. We found that administration rate had a greater impact on the perceived pain of lidocaine infiltration than did buffering.


手の外傷は縫合しなくてもいい?

  1. Suturing versus conservative management of lacerations of the hand: randomised controlled trial




手術の手洗いは滅菌水でなくてもよい

  1. 手術時手洗いにおける滅菌水と水道水の効果の比較
    • Author: 藤井昭ほか
    • Magazine: 日本手術医学会誌. 23;2002,2-9





酸性水は本当に有効なのか?

  1. 創傷治療における酸性水とポビドンヨードの消毒効果の比較



胃瘻が完成したらガーゼ保護は不要

  1. Careing for people with PEG in community.
    • Author: Reeves J, Cubbs H.
    • Magazine: Community Nurse 2000; May: 21-22.
    • Abstract:





滅菌手袋と未滅菌手袋では,感染率に有意差はない

  1. Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: A randomized controlled tria
    • Author: Perelman VS, Francis GJ, Rutledge T, Foote J, Martino F, Dranitsaris G.
    • Magazine: Annals of Emergency Medicine (March 2004 Volume 43 Number 3)
    • Abstract: Study objective Although sterile technique for laceration management continues to be recommended, studies supporting this practice are lacking. Using clean nonsterile gloves rather than individually packaged sterile gloves for uncomplicated wound repair in the emergency department may result in cost and time savings. This study is designed to determine whether the rate of infection after repair of uncomplicated lacerations in immunocompetent patients is comparable using clean nonsterile gloves versus sterile gloves.
      METHODS: A prospective multicenter trial enrolled 816 individuals who were randomized to have their wounds repaired by using sterile or clean nonsterile gloves. The attending physician or resident completed a checklist describing patient, wound, and management characteristics. The patients were provided with a questionnaire to be completed by the physician who removed their sutures at the prescribed time and indicated the presence or absence of infection. When follow-up forms were not returned, a telephone call was made to the patient to determine whether he or she had experienced any wound complications.
      RESULTS: Follow-up was obtained for 98% of the sterile gloves group and 96.6% of the clean gloves group. There was no statistically significant difference in the incidence of infection between the 2 groups. The infection rate in the sterile gloves group was 6.1% (95% confidence interval [CI] 3.8% to 8.4%) and was 4.4% in the clean gloves group (95% CI 2.4% to 6.4%). The relative risk of infection was 1.37 (95% CI 0.75 to 2.52).
      CONCLUSION: This study demonstrated that there is no clinically important difference in infection rates between using clean nonsterile gloves and sterile gloves during the repair of uncomplicated traumatic lacerations.


  2. Clean versus sterile gloves: which to use for postoperative dressing changes?
    • Author: St Clair K, Larrabee JH.
    • Magazine: Outcomes Manag. 2002 Jan-Mar;6(1):17-21.
    • Abstract: Staff nurses have a key role in ensuring that practice is evidenced-based. This article discusses the application of a model for evidence-based practice change by staff nurses in an acute care setting who examined the practice of using sterile gloves for postoperative wound dressing changes. This initiative was in response to the challenge that it was unnecessary to use sterile instead of nonsterile gloves. Extensive literature search revealed insufficient evidence to justify a practice change to nonsterile gloves.


  3. The use of sterile versus nonsterile gloves during out-patient exodontia.
    • Author: Giglio JA, Rowland RW, Laskin DM, Grenevicki L, Roland RW.
    • Magazine: Quintessence Int 1995 Aug;26(8):533.
    • Abstract: One hundred twenty-four patients who showed no clinical evidence of acute infection, were not taking antibiotics, and were to undergo routine removal of erupted teeth were studied. Patients were alternately assigned to surgeons who were wearing sterile or nonsterile, but clean, gloves. Surgery was performed in the usual manner and no postoperative antibiotics were prescribed. None of the patients was found to be infected postoperatively. Results of this prospective study suggest that routine exodontia can be safely performed by a surgeon wearing nonsterile, but surgically clean, gloves without increasing the risk of postoperative infection.






皮下注射前のアルコール消毒は必要ない?

  1. 皮下注射前のアルコール消毒は必要か −予防接種におけるランダム化比較試験ー


Top Page