Ovington Liza
Ovington and Associates, Pittsburgh, PA, USA.
Ostomy Wound Manage. 2003 Jul;49(7A Suppl):8-12.
Infection--a factor commonly related to delayed closure for many chronic and acute wounds--is associated with relatively high levels of bacteria in viable tissues. But bacteria also can delay wound healing at lower levels before tissue invasion via toxin secretion either directly from viable cells (exotoxins) or as a result of cell lysis (endotoxins). These toxins tend to cause local necrosis and disrupt the delicate balance of critical mediators such as cytokines and proteases necessary for healing progression. Therefore, toxin control or absorption is a potentially valuable adjunct to any infection control modality. A long-standing method of controlling toxins of many types is the use of high surface area adsorbents, such as activated charcoal. Recent data suggest that activated charcoal may offer specific advantages in topical wound management through its effects on bacterial toxins.
感染——许多慢性和急性伤口延迟愈合的常见相关因素——与存活组织中相对较高水平的细菌有关。但在细菌通过活细胞直接分泌毒素（外毒素）或细胞裂解（内毒素）侵入组织之前，较低水平的细菌也会延迟伤口愈合。这些毒素往往会导致局部坏死，并破坏愈合过程中所需的关键介质（如细胞因子和蛋白酶）的微妙平衡。因此，毒素控制或吸收是任何感染控制方式的潜在有价值辅助手段。控制多种毒素的一种长期方法是使用高表面积吸附剂，如活性炭。最近的数据表明，活性炭可能通过其对细菌毒素的作用在局部伤口管理中具有特定优势。
