负压创面疗法与常规无菌纱布对感染创面愈合影响的比较

Negative pressure wound therapy versus gauze dressing for Pseudomonas aeruginosa infected wound

  • 摘要: 目的 比较负压创面疗法与常规纱布覆盖对铜绿假单胞菌感染软组织创面的治疗效果。 方法 取巴马香猪18只,在背部建立一个直径50 mm深达肌肉层的铜绿假单胞菌感染创面,随机分为实验组(负压创面疗法)和对照组(无菌纱布),每组9只,分别采用负压创面疗法和常规纱布覆盖治疗。于建模成功后及治疗第4、8、12、16天定量检测创面大小并取创面肌肉组织标本用于VEGF和TGF-β1表达的检测及新生毛细血管观察。 结果 创面愈合定量分析显示实验组治疗第8、12、16天时创面直径明显小于对照组(P均< 0.01),第16天时两组创面直径大小分别为(15.6±5.1) mm和(28.7±6.5) mm;肉芽组织厚度定量分析显示治疗第4、8、12和16天时实验组明显高于对照组(P均< 0.01),第16天时两组肉芽组织厚度分别为(13 236.4±305.8)μm和(9 451.2±491.3)μm。治疗第16天时VEGF表达水平实验组是对照组的1.25倍(P< 0.01);而TGF-β1的表达水平在第16天时实验组是对照组的1.3倍(P< 0.01);新生毛细血管面积定量分析显示在治疗第16天时实验组是对照组的1.28倍(P< 0.01)。 结论 与常规纱布覆盖治疗相比,负压创面疗法治疗下细菌感染创面愈合速度更快,创面新生肉芽组织更厚,这可能是负压创面疗法促进创面愈合的机制之一。

     

    Abstract: Objective To compare the effect of negative pressure wound therapy (NPWT) and conventional gauze dressing on Pseudomonas aeruginosa infected wound healing. Methods Eighteen Bama miniature pigs were included in this study, and they were randomly divided into experimental group (n=9) with negative pressure wound therapy and control group (n=9) with conventional gauze dressing. A 5 cm×5 cm full-thickness wound infected by Pseudomonas aeruginosa was created on back of each pig. After the infected model was established successfully, the sizes of wounds were evaluated quantitatively, and muscular tissues were collected for analysis of VEGF and TGF-β1 expression at day 0, day 4, day 8, day 12 and day 16. Results The quantitative analysis of wound healing degree showed the wound size in NPWT group was significantly smaller than that in the control group at day 8, 12 and 16 (all P< 0.01, day 16, 15.6±5.1 mm vs 28.7±6.5 mm);granulation tissue thickness in the NPWT group was significantly greater than the control group at day 4, 8, 12 and 16 (all P< 0.01, day 16, 13 236.4±305.8μm vs 9 451.24±491.3μm). At day 16, the expression level of VEGF in NPWT group was 1.25 times of the control, TGF-β1 1.3 times, area of newborn capillaries 1.28 times (P< 0.01, respectively). Conclusion The healing of Pseudomonas aeruginosa infected wound is faster under negative pressure wound therapy and the new granulation tissue thickness is also relatively greater in NPWT group, which may be one of the mechanisms of negative pressure wound therapy to promote wound healing.

     

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