Peter F W, Li-Peuser H, Vogt P M, Muehlberger T, Homann H H, Steinau H U
Department of Plastic Surgery, Burn Center, Hand Center, Bergmannsheil University Hospital, Bochum, Germany.
Clin Exp Dermatol. 2002 Jan;27(1):51-5. doi: 10.1046/j.0307-6938.2001.00937.x.
An intact microcirculation is essential for normal healing to occur. Wound repair may be impaired by various endogenous and exogenous factors, such as reduced microvascular perfusion, infection and debris. In the nonhealing wound, radical surgical debridement is critical. To supplement healing, various ointments are used in clinical practice. Little is known about their effects on tissue perfusion. We have therefore selected two substances widely used, the antiseptic Betadine and the enzyme combination Elase and investigated their impact on the microcirculation and on leucocyte activity, using the cremaster muscle as a model. We found that functional capillary density and arteriolar diameters were significantly reduced by Betadine, whereas leucocyte activity was not affected. In the Elase group, capillary flow and arteriolar diameters were significantly increased, and again leucocyte activity was not changed. The mechanism by which Betadine reduces microvascular flow is believed to be the same as in reperfusion injury. The positive effect of Elase on the microcirculation might be attributed to plasmin, which has been shown to dilate blood vessels.
完整的微循环对于正常愈合的发生至关重要。伤口修复可能会受到各种内源性和外源性因素的损害，如微血管灌注减少、感染和碎屑。在不愈合的伤口中，彻底的手术清创至关重要。为了辅助愈合，临床实践中使用了各种药膏。关于它们对组织灌注的影响知之甚少。因此，我们选择了两种广泛使用的物质，防腐剂聚维酮碘和酶组合弹性酶，并以提睾肌为模型研究了它们对微循环和白细胞活性的影响。我们发现聚维酮碘显著降低了功能性毛细血管密度和小动脉直径，而白细胞活性未受影响。在弹性酶组中，毛细血管血流和小动脉直径显著增加，白细胞活性同样未改变。聚维酮碘减少微血管血流的机制被认为与再灌注损伤相同。弹性酶对微循环的积极作用可能归因于纤溶酶，纤溶酶已被证明可扩张血管。
