Martineau Lucie, Shek Pang N
Operational Medicine Section, Trauma Group, Defence Research and Development Canada Toronto, 1133 Sheppard Avenue West, Toronto, Ont., Canada M3M 3B9.
Burns. 2006 Mar;32(2):172-9. doi: 10.1016/j.burns.2005.08.012.
We have recently designed a medicated bi-layer wound dressing to address the key requirements for treating external, contaminated war wounds. This study assessed the in vitro and in vivo bactericidal efficacies of the DRDC hydrogel/polyurethane wound dressing. Chloramphenicol- and chlorhexidine-loaded DRDC dressings produced significantly larger zones of inhibition against Pseudomonas aeruginosa than the other medicated dressings for 4 d. Chlorhexidine-loaded Allevyn and Hydrasorb remained bactericidal for 48 h only. Chloramphenicol-loaded Hydrasorb and Allevyn remained bactericidal for 1 and 3 d, respectively. Ps. aeruginosa and Staphylococcus epidermidis counts in wounds treated with chlorhexidine- and chloramphenicol-loaded DRDC dressings for 24 h were 1-3-log lower than those of control wounds. While Ps. aeruginosa counts in the wounds on day 4 were comparable following daily changes of either antiseptic-loaded dressings, chlorhexidine showed a 75% greater bactericidal efficacy against Staph. epidermidis than chloramphenicol. Though increasing the frequency of dressing changes led to a greater reduction in the wound bacterial load, the contamination levels of all antiseptic-treated wounds remained below 10(5) CFU/g of wound. Cerium nitrate-loaded dressings did not exert any bactericidal effect, irrespective of the experimental conditions. These data show that the DRDC dressing is effective in delivering medications, such as an antimicrobial agent, to the wound bed.
我们最近设计了一种含药双层伤口敷料，以满足治疗外部污染战伤的关键要求。本研究评估了DRDC水凝胶/聚氨酯伤口敷料的体外和体内杀菌效果。载有氯霉素和洗必泰的DRDC敷料在4天内对铜绿假单胞菌产生的抑菌圈明显大于其他含药敷料。载有洗必泰的爱立敷和水凝胶仅在48小时内保持杀菌作用。载有氯霉素的水凝胶和爱立敷分别在1天和3天内保持杀菌作用。用载有洗必泰和氯霉素的DRDC敷料处理24小时的伤口中，铜绿假单胞菌和表皮葡萄球菌的数量比对照伤口低1-3个对数。虽然在每天更换含抗菌剂敷料后，第4天伤口中的铜绿假单胞菌数量相当，但洗必泰对表皮葡萄球菌的杀菌效果比氯霉素高75%。尽管增加换药频率导致伤口细菌载量有更大程度的降低，但所有经抗菌剂处理的伤口的污染水平仍低于10(5)CFU/g伤口。无论实验条件如何，载有硝酸铈的敷料均未发挥任何杀菌作用。这些数据表明，DRDC敷料能有效地将抗菌剂等药物输送到伤口床。
