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局部和全身应用左旋肉碱对全层皮肤缺损愈合影响的初步研究。

Preliminary study comparing the effects of locally and systemically applied L-carnitine on the healing of full-thickness skin defects.

机构信息

General Surgery Department, Haseki Education and Research Hospital, Istanbul, Turkey.

出版信息

Scand J Surg. 2010;99(3):147-52. doi: 10.1177/145749691009900309.

Abstract

BACKGROUND AND AIMS

L-carnitine as an endogenous cofactor has a role in the regulation of energy flow between different oxidative sources. The purpose of this study is to investigate that the clinical and histopathologic effects of L-carnitine locally and systemically on secondary healing in wounds of full thickness defects. We also measured the effects of L-carnitine on wound tensile strength as mechanical.

MATERIAL AND METHODS

sixty adult male Sprague-Dawley rats were divided into three groups randomly; group 1 (control group, n = 20), group 2 (local experimental group, n = 20), group 3 (systemic experimental group, n = 20). Group 1 was not given any pharmacologic agents. L-carnitine was administered locally in the group 2, and systemically in group 3 for a total of 14 days. The healing days of all groups were recorded. On the 7th, 10th,14th and 21st postoperative days, biopsy specimens, including tissue samples both from healing wound sites and sur-rounding healthy skin were evaluated for neovascularization, inflammation, the amount of collagen deposit, fibroblast migration and re-epithelization. Tensile strength was measured in the samples which completed healing on the 30th day. The results were evaluated by nonparametric Kruskall-Wallis test followed by Mann Whitney-U test.

RESULTS

the mean clinical healing days were 18.25 days, 16.5 days, 15 days for the control group, local experimental and systemic group, respectively. The differences between groups were statistically significant (p < 0.005). Mean tensile strength values were 762.10 centinewton (cN), 801.69 cN and 786.13 cN for the control group, local experimental group and systemic experimental group, respectively. There were no statistically significant differences between groups (p > 0.05). There was no statistically significant difference in the histopathologic ex-amination on the 7th, 10th, 14th and 21st days in the neovascularization, inflammation and fibroblast migration. Collagen deposit was most prevalent in the systemic experimental group and was least in the control group. Complete wound closure rate was observed on the 7th day in the systemic administration group, on the 10th day in local administration group and on the 14th day in the control group. Re-epithelization thickness in the systemic carnitine group was more than the other groups.

CONCLUSIONS

L-carnitine administered locally or systemically has positive effects on wound healing rate and tensile strength in rats.

摘要

背景与目的

左旋肉碱作为一种内源性辅助因子,在调节不同氧化源之间的能量流动方面发挥作用。本研究旨在探讨左旋肉碱局部和全身给药对全层缺陷伤口继发性愈合的临床和组织病理学影响。我们还测量了左旋肉碱对伤口拉伸强度的机械作用。

材料和方法

60 只成年雄性 Sprague-Dawley 大鼠随机分为三组:第 1 组(对照组,n = 20)、第 2 组(局部实验组,n = 20)、第 3 组(全身实验组,n = 20)。第 1 组未给予任何药物治疗。第 2 组局部给予左旋肉碱,第 3 组全身给予左旋肉碱,共 14 天。记录所有组的愈合天数。在术后第 7、10、14 和 21 天,对包括愈合伤口部位和周围健康皮肤的组织样本进行活检,以评估新生血管、炎症、胶原沉积量、成纤维细胞迁移和再上皮化。在第 30 天完成愈合的样本中测量拉伸强度。结果采用非参数 Kruskal-Wallis 检验,然后采用 Mann-Whitney-U 检验进行评估。

结果

对照组、局部实验组和全身实验组的平均临床愈合天数分别为 18.25 天、16.5 天和 15 天。组间差异有统计学意义(p < 0.005)。对照组、局部实验组和全身实验组的平均拉伸强度值分别为 762.10 厘牛顿(cN)、801.69 cN 和 786.13 cN。组间差异无统计学意义(p > 0.05)。在第 7、10、14 和 21 天的新生血管、炎症和成纤维细胞迁移的组织病理学检查中,差异无统计学意义。胶原沉积在全身实验组最为普遍,在对照组最少。全身给药组第 7 天观察到完全伤口闭合,局部给药组第 10 天观察到完全伤口闭合,对照组第 14 天观察到完全伤口闭合。全身肉碱组的再上皮化厚度大于其他组。

结论

左旋肉碱局部或全身给药对大鼠伤口愈合率和拉伸强度有积极影响。

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