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莫斯手术后二次意图治愈的心理社会和炎症后果:对多学科术后护理的影响
Johanna Ghebrehiwet-Kuflom1,2, Anuj Budhiraja1,3, Alisha Mehta1,3
1Dermatology Section, VA Northern California Health Care System, Mather, CA, USA.
概括
心理压力可以通过增加炎症来延迟莫斯手术后的伤口愈合. 解决这种心理社会-炎症反循环可能会改善恢复时间和患者的生活质量.
科学领域:
- 皮肤病学 皮肤病学
- 心理神经免疫学 心理神经免疫学
- 伤口愈合生物学 伤口愈合生物学
背景情况:
- 在莫斯微图手术 (MMS) 后的二次意图愈合对于复杂或的部位是常见的.
- 这种治疗方法可能会导致长时间的恢复,痕和心理社会困扰.
- 心理压力通过神经内分泌路径对伤口修复产生负面影响,延迟炎症的解决.
研究的目的:
- 审查支持MMS中"心理社会-炎症反循环"的证据.
- 解释二次意图伤口中延长的愈合时间.
- 为临床实践提供有关伤口关闭和患者护理的信息.
主要方法:
- 在体外,动物和临床发现的整合.
- 心理神经免疫学和伤口生物学文献的综述.
- 开发框架来解释心理社会-炎症循环.
主要成果:
- 心理压力会增加皮质醇和甲醇胺,破坏免疫功能和炎症解决.
- 炎症阻碍纤维细胞活动,细胞外矩阵重塑和原组织,减缓伤口关闭.
- 在可见的伤口增加痛苦的地方存在反循环,这会放大炎症并延迟愈合.
结论:
- 心理社会-炎症反循环在MMS中是生物可信和临床相关的.
- 了解这种相互作用对于选择关闭方法,患者咨询和术后护理至关重要.
- 包括心理支持在内的多学科策略可以加速愈合并提高患者的生活质量.
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