Homann Heinz H, Hirsch Tobias, Steinau H U, Muehlberger Thomas, Moll Wibke, Lehnhardt Marcus, Goertz Ole
Eplasty. 2011 Jan 20;11:e2.
Impaired microcirculation is one of the most important factors in delayed wound healing. The aim of the study was to investigate the influence of chemical and surgical interruption of sympathetic nerve fibers and α- and β-receptors blockers on muscular microcirculation.
The experiment was performed on a standardized cremaster muscle model of male Wistar rats (n=51). Microcirculation was recorded via transillumination microscopy on each of the 4 test groups and in a control group before and after their respective treatments with one of the following: topical application of bupivacaine, metoprolol, phentolamine, or surgical denervation. The arteriolar diameter and functional capillary density (FCD) as parameter for tissue perfusion were assessed.
The α-blocker phentolamine was the only agent that caused a significant dilation of the arteriolar diameter (76.6 ± 6.9 vs 100.0 ± 12.0 µm). However, like bupivacaine, metoprolol, and the surgical sympathectomy, it did not improve FCD as a parameter for tissue perfusion. The strongest vasoconstriction (35.9 ± 4.3 vs 28.6 ± 4.0) and impairment of the FCD (10.0 ± 0.7 vs 4.1 ± 0.9) was induced by the β-blocker metoprolol.
This study shows that phentolamine could be an agent for dilating arteriolar diameter, but it did not improve FCD. Whereas the other agents, including sympathectomy, did not alter arteriolar diameter, the β-blocker worsened both investigated parameters. Our results raise the question whether β-blockers negatively influence microcirculation. Therefore, further studies are needed to investigate the potential adverse effects of β-blockers on wound healing.
微循环受损是伤口愈合延迟的最重要因素之一。本研究的目的是探讨交感神经纤维的化学和手术阻断以及α和β受体阻滞剂对肌肉微循环的影响。
在雄性Wistar大鼠(n = 51)的标准化提睾肌模型上进行实验。通过透照显微镜记录4个试验组和1个对照组在分别用以下方法之一进行治疗前后的微循环情况:局部应用布比卡因、美托洛尔、酚妥拉明或手术去神经。评估小动脉直径和作为组织灌注参数的功能性毛细血管密度(FCD)。
α受体阻滞剂酚妥拉明是唯一能使小动脉直径显著扩张的药物(76.6±6.9对100.0±12.0μm)。然而,与布比卡因、美托洛尔和手术交感神经切除术一样,它并未改善作为组织灌注参数的FCD。β受体阻滞剂美托洛尔引起最强的血管收缩(35.9±4.3对28.6±4.0)和FCD受损(10.0±0.7对4.1±0.9)。
本研究表明酚妥拉明可能是一种扩张小动脉直径的药物,但它并未改善FCD。而其他药物,包括交感神经切除术,并未改变小动脉直径,β受体阻滞剂使两个研究参数均恶化。我们的结果提出了β受体阻滞剂是否对微循环有负面影响的问题。因此,需要进一步研究来探讨β受体阻滞剂对伤口愈合的潜在不良影响。