医用隐形抗菌膜抑制手术切口瘢痕形成的实验

背景:研究证实壳聚糖能抑制瘢痕形成和影响创伤愈合,医用抗菌膜是一种以壳聚糖为基质的新型膜材料.目的:考察医用隐形抗菌膜对手术切口瘢痕形成的抑制作用,并观察对伤口愈合的影响.设计、时间及地点:同体对照动物实验,于2007-08/10在四川大学华西药学院IVC实验动物房完成.材料:医用隐形抗菌膜原液,为无色透明微黏性液体,喷涂于附着面后形成无色透明薄膜,规格:40 mL,成都超吉科技有限公司提供(批号070501).方法:取20-23 d龄SD大鼠16只,于其背部皮肤作全程线形切口,右侧为实验组,左侧为对照组.造成手术切口后,实验组喷医用隐形抗菌膜原液0.5 mL/次,1次,d,共3 d,对照组给予等量注射用0.9%氯化钠注射液,任其自然痊愈.主要观察指标:于术后3,7,14d取切口处皮肤组织,作苏木精-伊红染色、Masson染色,病理检测以判断伤口愈合及瘢痕形成情况,并进行瘢痕面积分析.结果:术后14 d实验组相对瘢痕面积为98 200+34 719,对照组相对瘢痕面积为154 069±51 356,两组比较差异有显著性意义(P<0.05).术后14 d,光镜观察实验组有较少胶原纤维和成纤维细胞堆积;术后3 d,与对照组相比,实验组上皮化较快,有较多肉芽组织和较少炎性细胞浸润.结论:医用隐形抗菌膜能显著抑制手术切口瘢痕增生,且不影响伤口愈合.

Experimental study on inhibiting operative incision scar formation using medical invisible antimicrobial film

BACKGROUND: It has been reported that chitosan can inhibit scar formation and promote wound healing. Medical invisible antimicrobial film is a new type of membrane materials which comprises chitosan as ground substance.OBJECTIVE: To determine the inhibitory effects of medical invisible antimicrobial film on the operative incision scar, and to observe its effects on wound healing.DESIGN, TIME AND SETTING: A controlled animal study was conducted at the IVC Experimental Animal Room, West China School of Pharmacy, Sichuan University from August to October 2007.MATERIALS: Medical invisible antimicrobial film stock solution was colorless transparent sticking solution, which formed colorless transparent film following spray painting (specification: 40 mL), provided by Chengdu Chaojl Technology Co., Ltd. (lot number 070501).METHODS: A total of 16 healthy Sprague Dawley rats aged 20 to 23 days were selected. Full linear skin incisions were operated in aseptic condition. After operation, the experimental group (right side) was sprayed medical invisible antimicrobial film 0.5 mL/time, once a day, for totally 3 days. The control group (left side) received an equal volume of 0.9% sodium chloride injection, with natural cure.MAIN OUTCOME MEASURES: At 3, 7 and 14 days following surgery, incision skin specimens were obtained, and subjected to hematoxylin-eosin staining and Masson staining was applied to observe wound healing and the formation of scar, then the scar area was analyzed.RESULTS: The scar relative mean area of control group was 154 069±51 356 and the experimental group was 98 200±34 719 on the postoperative 14~(th) day. The two groups were significantly different (P < 0.05). At 14 days following surgery, optical microscope showed that the experiment group had less collagen fibers and fibroblast accumulation. At 3 days, compared with the control group, the experimental group had less epithelization period, more granulation tissue and less inflammatory cell infiltration.CONCLUSION: The medical invisible antimicrobial film has inhibitory effect of the formation of operative incision scar, and no influence on wound healing of operative incision.