Department of Plastic Surgery and Burn Center, Gulhane Military Medical Academy and Medical School, 060018 Etlik, Ankara, Turkey.
Burns. 2012 Mar;38(2):283-9. doi: 10.1016/j.burns.2011.08.008. Epub 2011 Oct 19.
Cerium nitrate (CN) was used as a topical antiseptic agent for the treatment of burn wounds and found to reduce the number of anticipated death in burn. This decreased burn related mortality cannot be explained by the control of wound infection alone. In the studies performed to elucidate the unexplained effects of CN treatment, it was shown that CN treatment reduced the alarm cytokine levels, decreased leukocyte activation, reduced macromolecular leakage and finally burn edema formation. We hypothesized that CN treatment prevents the conversion of the zone of stasis to progressive tissue necrosis by decreasing leukocyte activation and reducing macromolecular leakage and burn edema. This was investigated on a well-described burn comb model in the rats. Fifty-four rats were randomly divided into control and CN treatment groups. Each rat in CN treatment group received 0.04 M CN bathing 30 min after burn whereas rats in control group received 0.09% saline bathing. Viability of zone of stasis is assessed with (99 m)Tc-sestamibi scintigraphy. Nine rats in each group were scintigraphically evaluated at the 3rd and 7th day after burn and remaining 9 rats had macroscopic and histological examination at the 21st day after burn to confirm the scintigraphic results. In CN treatment groups, the scintigraphic uptake ratios were higher both at post burn day 3rd and 7th when compared to that of control groups. This was statistically significant (p≤0.05). In the CN treatment group, the results of the average percentage of the re-epithelialization in the zone of stasis were higher than that of control groups. The difference between the groups was also statistically significant (p≤0.05). These results were accepted that CN treatment prevents progressive tissue necrosis in the zone of stasis. This study further elucidates the unexplained effects of CN treatment on burn.
硝酸铈（CN）曾被用作治疗烧伤创面的局部抗菌剂，研究发现它可以降低烧伤患者的死亡率。这种降低烧伤相关死亡率的效果不能仅用控制创面感染来解释。在对 CN 治疗效果进行的研究中，发现 CN 治疗可以降低警报细胞因子水平，减少白细胞活化，减少大分子渗漏，最终减少烧伤水肿形成。我们假设 CN 治疗通过减少白细胞活化和减少大分子渗漏及烧伤水肿来防止瘀滞区向进行性组织坏死转化。我们在大鼠烧伤模型中对此进行了研究。
54 只大鼠随机分为对照组和 CN 治疗组。CN 治疗组的每只大鼠在烧伤后 30 分钟接受 0.04 M CN 浴疗，而对照组的大鼠接受 0.09%生理盐水浴疗。采用（99m）Tc-甲氧基异丁基异腈闪烁扫描术评估瘀滞区的活力。每组 9 只大鼠在烧伤后第 3 天和第 7 天进行闪烁扫描评估，其余 9 只大鼠在烧伤后第 21 天进行大体和组织学检查以确认闪烁扫描结果。在 CN 治疗组中，与对照组相比，在烧伤后第 3 天和第 7 天，扫描摄取比值均更高，且具有统计学差异（p≤0.05）。在 CN 治疗组中，瘀滞区再上皮化的平均百分比高于对照组，且差异具有统计学意义（p≤0.05）。这些结果表明 CN 治疗可以预防瘀滞区的进行性组织坏死。该研究进一步阐明了 CN 治疗对烧伤的未知效果。
