Department of Plastic and Reconstructive Surgery, Erasmus University Hospital, Rotterdam, The Netherlands.
J Wound Ostomy Continence Nurs. 2011 Sep-Oct;38(5):522-8. doi: 10.1097/WON.0b013e31822ad290.
The aim of this study was to investigate the influence of oxidized regenerated cellulose/collagen matrix on the concentration and activity of gelatinases, elastase, and plasmin in wound exudate.
The study included 32 patients with diabetic foot ulcers. Ten patients with a mean age of 66 ± 9 years (mean ± SD) were treated with hydrocolloid dressings; 22 patients with a mean age of 57 ± 12 years were treated with oxidized regenerated/collagen matrix and hydrocolloid dressings.
Wound exudate was collected on days 0, 5, 14, and every 14 days thereafter for 12 weeks. Total protein was determined according to Bradford's technique. The levels of elastase and plasmin were measured spectrofluorometrically. Besides, gelatinase activity and matrix metalloproteinase-2 concentration were analyzed. The surface area of all ulcers was measured by planimetry.
Patients treated with oxidized regenerated cellulose/collagen matrix showed a significant decrease in elastase, plasmin, and gelatinase activities in wound exudates. The matrix metalloproteinase-2 concentration was significantly reduced on days 14, 28, 42, and 56 in comparison to day 0. Furthermore, wound size was significantly reduced at days 14 and 28 in oxidized regenerated cellulose/collagen matrix-treated patients (P < .05).
Our results showed a significant and immediate reduction in the levels of all tested proteases in the wound exudate of diabetic foot ulcer patients treated with oxidized regenerated cellulose/collagen matrix. These patients also experienced a significantly greater reduction in wound size.
本研究旨在探讨氧化再生纤维素/胶原基质对创面渗液中明胶酶、弹性蛋白酶和纤溶酶浓度和活性的影响。
本研究纳入了 32 例糖尿病足溃疡患者。10 例平均年龄为 66±9 岁（均数±标准差）的患者接受水胶体敷料治疗；22 例平均年龄为 57±12 岁的患者接受氧化再生/胶原基质和水胶体敷料治疗。
在第 0、5、14 天和此后每 14 天收集创面渗液，共 12 周。根据 Bradford 技术测定总蛋白。采用荧光分光光度法测定弹性蛋白酶和纤溶酶的水平。此外，还分析了明胶酶活性和基质金属蛋白酶-2 浓度。通过平面测量法测量所有溃疡的表面积。
接受氧化再生纤维素/胶原基质治疗的患者，创面渗液中的弹性蛋白酶、纤溶酶和明胶酶活性明显下降。与第 0 天相比，第 14、28、42 和 56 天基质金属蛋白酶-2 浓度显著降低。此外，与第 0 天相比，氧化再生纤维素/胶原基质治疗的患者在第 14 和 28 天的创面面积显著缩小（P<0.05）。
我们的结果显示，氧化再生纤维素/胶原基质治疗的糖尿病足溃疡患者创面渗液中所有检测蛋白酶的水平均显著且即刻降低，这些患者的创面面积也显著缩小。
