Shi Chong-Ming, Nakao Hiroshi, Yamazaki Masashi, Tsuboi Ryoji, Ogawa Hideoki
Department of Dermatology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Arch Dermatol Res. 2007 Nov;299(9):449-56. doi: 10.1007/s00403-007-0776-3. Epub 2007 Aug 7.
The topical application of a mixture of sugar and povidone-iodine (PI) has been reported to accelerate the healing of cutaneous wounds and ulcers by promoting reepithelialization and granulation tissue formation, as well as by having an anti-microbial effect. In order to clarify the efficacy of a 70% sugar and 3% PI paste (U-PASTA(SP) on infectious skin ulcers, we made a bacterial infection model using methicillin-resistant Staphylococcus aureus (MRSA) on the skin of diabetic db/db mice, and investigated the effect of the paste on the healing process of wounds. Full-thickness wounds were made on the backs of female diabetic mice, (C57BL/ksJ db/db) and inoculated with S. aureus. SP was applied to the closed wounds for 8 days. The degree of repair was evaluated using three histological parameters: The degree of reepithelialization was given a percentage value of 0-100%; the amount of granulation tissue was quantified by measuring the area of granulation (mm(2)); and the number of capillary lumens in the granulation tissue was counted in the complete wound cross-section at 100x magnification. In addition, the colony-forming units (CFU) of MRSA on the wounds were counted. Continuous MRSA infection in the wounds of db/db mice was demonstrated with macroscopic and histopathological images. Wounding and infection caused by MRSA on the back of the diabetic mice significantly induced delayed reepithelialization, granulation tissue formation with inflammatory cell infiltrate and increased CFU on wounds (P < 0.01, respectively) compared to those of the MRSA-infected normal mice. Application of SP significantly accelerated reepithelialization (P < 0.01) and decreased CFU (P < 0.05) of the ulcers in the MRSA-infected wounds, compared to the non-treated group. Histopathological evaluation and CFU on this animal model revealed no significant difference between Methicilin-sensitive Staphylococcus aureus and MRSA infection. These results indicate that wounding on db/db mice provides a useful animal model of bacterial skin infections, and that SP is an effective topical agent for the treatment of diabetic skin ulcers.
据报道，糖与聚维酮碘（PI）混合物的局部应用可通过促进表皮再形成和肉芽组织形成以及发挥抗菌作用来加速皮肤伤口和溃疡的愈合。为了阐明70%糖和3%PI糊剂（U-PASTA(SP)）对感染性皮肤溃疡的疗效，我们在糖尿病db/db小鼠皮肤上建立了耐甲氧西林金黄色葡萄球菌（MRSA）的细菌感染模型，并研究了该糊剂对伤口愈合过程的影响。在雌性糖尿病小鼠（C57BL/ksJ db/db）背部制造全层伤口，并接种金黄色葡萄球菌。将SP应用于闭合伤口8天。使用三个组织学参数评估修复程度：表皮再形成程度给予0-100%的百分比值；通过测量肉芽面积（mm²）对肉芽组织量进行定量；在100倍放大倍数下在完整伤口横截面上计数肉芽组织中的毛细血管腔数量。此外，对伤口上的MRSA菌落形成单位（CFU）进行计数。通过宏观和组织病理学图像证实了db/db小鼠伤口中存在持续性MRSA感染。与MRSA感染的正常小鼠相比，糖尿病小鼠背部由MRSA引起的创伤和感染显著导致表皮再形成延迟、伴有炎性细胞浸润的肉芽组织形成以及伤口上CFU增加（分别为P < 0.01）。与未治疗组相比，应用SP显著加速了MRSA感染伤口溃疡的表皮再形成（P < 0.01）并降低了CFU（P < 0.05）。对该动物模型的组织病理学评估和CFU显示，甲氧西林敏感金黄色葡萄球菌感染与MRSA感染之间无显著差异。这些结果表明，db/db小鼠的创伤提供了一种有用的细菌性皮肤感染动物模型，并且SP是治疗糖尿病皮肤溃疡的有效局部用药。
