Goertz Ole, Hirsch Tobias, Ring Andrej, Steinau Hans U, Daigeler Adrien, Lehnhardt Marcus, Homann Heinz H
Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.
Ann Plast Surg. 2011 Oct;67(4):407-12. doi: 10.1097/SAP.0b013e318209a5fc.
Bacterial infections cause major complications in wound healing. Local antiseptics are used for daily wound care; however, their potential toxic effects on the vasculature have not yet been thoroughly investigated. The aim of this study was to assess the effects of antiseptics on microcirculation. Investigations were performed on a standardized cremaster muscle model on rats (n = 60). The arteriolar diameter and functional capillary density (FCD) were investigated using transillumination microscopy before and 60 and 120 minutes after application of each of the following antimicrobial agents: alcohol, hydrogen peroxide, imipenem, octenidine dihydrochloride, polyhexanide, and ethacridine lactate. Although polyhexanide caused a significant arteriolar dilatation (106.25 ± 3.23 vs. 88.54 ± 6.74 μm [baseline value]) and increase of FCD compared with baseline value (12.65 ± 0.82 vs. 9.10 ± 0.50 n/0.22 mm), alcohol led to a significant decrease of both parameters (90.63 ± 10.80 vs. 52.09 ± 7.69 and 5.35 ± 0.54 vs. 1.68 ± 0.48) and was the only agent that caused arteriolar thrombosis. The FCD also increased significantly after treatment with hydrogen peroxide (10.55 ± 0.33 vs. 12.30 ± 0.48) and octenidine (6.82 ± 0.63 vs. 12.32 ± 0.63). However, no positive effect on arteriolar diameter could be found. Ethacridine lactate and imipenem did not impact either parameter. In addition to reducing bacteria, an antiseptic should be nontoxic, especially to the microcirculation. Polyhexanide seems to have a positive influence on vessel diameter and capillary density, whereas alcohol reduces both parameters. If the antimicrobial efficacy is comparable, the antiseptic with less toxic effects should be chosen, especially in critically perfused wounds.
细菌感染会在伤口愈合过程中引发严重并发症。局部防腐剂用于日常伤口护理；然而，它们对血管系统的潜在毒性作用尚未得到充分研究。本研究的目的是评估防腐剂对微循环的影响。研究在大鼠标准化提睾肌模型（n = 60）上进行。在应用以下每种抗菌剂之前以及应用后60分钟和120分钟，使用透照显微镜观察小动脉直径和功能性毛细血管密度（FCD）：酒精、过氧化氢、亚胺培南、盐酸奥替尼啶、聚己双胍和乳酸依沙吖啶。与基线值相比，尽管聚己双胍导致小动脉显著扩张（106.25±3.23对88.54±6.74μm[基线值]）且FCD增加（12.65±0.82对9.10±0.50 n/0.22 mm），但酒精导致这两个参数均显著降低（90.63±10.80对52.09±7.69以及5.35±0.54对1.68±0.48），并且是唯一导致小动脉血栓形成的药物。过氧化氢（10.55±0.33对12.30±0.48）和奥替尼啶（6.82±0.63对12.32±0.63）治疗后FCD也显著增加。然而，未发现对小动脉直径有积极影响。乳酸依沙吖啶和亚胺培南对这两个参数均无影响。除了减少细菌外，防腐剂应无毒，尤其是对微循环无毒。聚己双胍似乎对血管直径和毛细血管密度有积极影响，而酒精会降低这两个参数。如果抗菌效果相当，应选择毒性较小的防腐剂，尤其是在灌注不良的伤口中。
