Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.
Int Wound J. 2011 Aug;8(4):365-73. doi: 10.1111/j.1742-481X.2011.00800.x. Epub 2011 Jun 3.
The topical application of the antiseptics octenidine and polyhexanide on wounds seems to improve microcirculation. These two antiseptics were tested in combination with neuronal inhibition and sympathethic receptor blockade to verify these findings, explore the influence of β blockers on these microcirculative effects, and find out the principle of operation. Investigations were carried out on a standardised cremaster muscle model in rats (n = 66). The tested antiseptics, octenidine and polyhexanide were investigated alone (n = 12) and in combination with bupivacaine (n = 12), metoprolol (n = 12), phentolamine (n = 12) and surgical denervation (n = 12). Physiological saline was used for control (n = 6). The arteriolar diameter and functional capillary density (FCD) were investigated via trans-illumination microscopy before, as well as 60 and 120 minutes after application. Polyhexanide caused a significant increase in arteriolar diameter (86·5 ± 3·8 µm versus 100·0 ± 3·6 µm) and, like octenidine (7·2 ± 0·7 n/0·22 mm(2) versus 11·6 ± 0·6 n/0·22 mm(2) ), in FCD (9·2 ± 0·5 versus 12·6 ± 0·9) as well. When the antiseptics are used in combination with bupivacaine, metoprolol, phentolamine or surgical sympathectomy, these effects were eliminated or inverted. Assessing the results of the different blockades in combination with polyhexanide, we surmise that the antiseptic polyhexanide acts on the microcirculation mainly by blocking α receptors. This study shows that polyhexanide and octenidine improve muscular perfusion. Interestingly, the benefit of polyhexanide and octenidine on muscular perfusion is eliminated when the antiseptics are combined with other vasoactive agents, especially β blockers.
局部应用防腐剂奥替尼啶和聚己双胍似乎可以改善微循环。这两种防腐剂被测试与神经元抑制和交感神经受体阻断结合，以验证这些发现，探索β阻滞剂对这些微循环效应的影响，并找出操作原理。研究在大鼠标准化提睾肌模型上进行（n = 66）。单独测试了奥替尼啶和聚己双胍（n = 12）以及与布比卡因（n = 12）、美托洛尔（n = 12）、酚妥拉明（n = 12）和手术去神经支配（n = 12）组合。生理盐水用于对照（n = 6）。在应用前、应用后 60 和 120 分钟，通过透照显微镜研究了小动脉直径和功能性毛细血管密度（FCD）。聚己双胍导致小动脉直径显著增加（86.5 ± 3.8 µm 与 100.0 ± 3.6 µm），并且与奥替尼啶（7.2 ± 0.7 n/0.22 mm(2) 与 11.6 ± 0.6 n/0.22 mm(2)）一样，FCD 也增加（9.2 ± 0.5 与 12.6 ± 0.9）。当防腐剂与布比卡因、美托洛尔、酚妥拉明或手术交感神经切断术联合使用时，这些作用被消除或反转。评估不同阻断剂与聚己双胍联合使用的结果，我们推测防腐剂聚己双胍主要通过阻断α受体作用于微循环。这项研究表明，聚己双胍和奥替尼啶可改善肌肉灌注。有趣的是，当防腐剂与其他血管活性药物，尤其是β阻滞剂联合使用时，聚己双胍和奥替尼啶对肌肉灌注的益处被消除。
