Mahajan Ajay L, Tenorio Xavier, Pepper Michael Sean, Baetens Danielle, Montandon Denys, Schlaudraff Kai-Uwe, Pittet Brigitte
Department of Plastic and Reconstructive Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Burns. 2006 Dec;32(8):957-63. doi: 10.1016/j.burns.2006.02.010. Epub 2006 Aug 14.
Burn wounds are characterised by central necrosis surrounded by an area of stasis with compromised perfusion. Secondary aggravation of the burn wound due to ischaemia in the zone of stasis can also result in necrosis. This study aims to improve circulation in the zone of stasis by reducing microthrombus formation and thereby to reduce secondary aggravation.
Recombinant nematode anticoagulant protein (rNAPc2) was administered to Wistar rats at 3 or 30 microg/kg as a single or daily dose. A comb pattern burn was induced on the dorsum of these rats and its evolution monitored by serial photography, planimetry, laser doppler flowmetry and immunohistochemistry.
In the 30 microg/kg daily group, extension of the burn wound was curbed, limiting the burn area to 1.99+/-0.67 cm(2) on day 28, compared to 3.51+/-0.37 cm(2) in the control group (p=0.015). Laser doppler evaluation showed a significant (p<0.001) increase in circulation in the first day post-burn. Significantly less (p<0.001) microvascular fibrin formation was observed by immunohistochemistry.
Anticoagulation with rNAPc2 improved perfusion of the burn wound. The resultant reduction in the area of the burn led to earlier healing and less scar contracture.
烧伤创面的特征是中央坏死，周围是灌注受损的淤滞区。淤滞区缺血导致的烧伤创面继发性加重也可导致坏死。本研究旨在通过减少微血栓形成来改善淤滞区的血液循环，从而减少继发性加重。
将重组线虫抗凝血蛋白（rNAPc2）以3或30微克/千克的剂量作为单次或每日剂量给予Wistar大鼠。在这些大鼠的背部诱导梳状烧伤，并通过连续摄影、面积测量、激光多普勒血流仪和免疫组织化学监测其演变。
在30微克/千克每日剂量组中，烧伤创面的扩展得到抑制，在第28天时烧伤面积限制在1.99±0.67平方厘米，而对照组为3.51±0.37平方厘米（p=0.015）。激光多普勒评估显示烧伤后第一天血液循环显著增加（p<0.001）。免疫组织化学观察到微血管纤维蛋白形成明显减少（p<0.001）。
用rNAPc2进行抗凝可改善烧伤创面的灌注。烧伤面积的减少导致愈合更早且瘢痕挛缩更少。
