Department of Plastic and Reconstructive Surgery, Ben Gurion Health Sciences Faculty, Ben-Gurion University, Beer-Sheba, Israel.
Burns. 2012 Nov;38(7):1035-40. doi: 10.1016/j.burns.2012.02.011. Epub 2012 Mar 3.
Debridement of the burn eschar is a cornerstone of burn wound care. Rapid enzymatic debridement with a bromelain-based agent (Debriding Gel Dressing-DGD) has recently been investigated. The current study was designed to further investigate the selectivity of DGD to burned eschar in a larger number and more varied types of wounds.
A systematic animal experiment was conducted to determine the effects of DGD on normal, non-injured skin, burns, exposed dermis of donor sites, and skin punch biopsy wells. Partial thickness dermal burns and partial thickness skin graft donor sites were created on a pig and treated with a 4-h application of DGD or its control hydrating vehicle that does not have any activity except hydration. Punch biopsy samples were taken before and after treatment and microscopically assessed for evidence of tissue viability and its respective components thickness.
Rapid dissolution of the burn eschar was noted in all DGD but not vehicle treated burns. There was no apparent damage to the underlying sub eschar dermis, donor sites, normal skin or punch biopsy wells after exposure to DGD. While the thickness of the treated tissues slightly increased due to edema, the increase in dermal thickness was similar after treatment with DGD or its vehicle. The increase in the cross section surface area of the treated punch biopsy wells was similar after treatment with DGD and its control vehicle.
Exposure of the burn eschar to DGD results in its rapid dissolution. Exposure of normal skin or non-burned dermis to DGD has no effects demonstrating its selectivity to eschar.
烧伤焦痂的清创是烧伤创面处理的基石。最近研究了一种基于菠萝蛋白酶的快速酶法清创剂(清创凝胶敷料-DGD)。本研究旨在进一步研究 DGD 对更大数量和更多类型创面中烧伤焦痂的选择性。
进行了一项系统的动物实验,以确定 DGD 对正常、未受伤皮肤、烧伤、供体部位暴露真皮和皮肤打孔活检孔的影响。在猪身上创建部分厚度真皮烧伤和部分厚度皮肤移植供体部位,并应用 4 小时的 DGD 或不具有除水合作用之外任何活性的其对照水合载体进行治疗。在治疗前后采集打孔活检样本,并进行显微镜评估以确定组织活力及其各自组成部分的厚度。
所有 DGD 处理的烧伤焦痂均迅速溶解,但对照载体处理的烧伤焦痂则未溶解。暴露于 DGD 后,未观察到下伏亚焦痂真皮、供体部位、正常皮肤或打孔活检孔有明显损伤。尽管由于水肿导致处理组织的厚度略有增加,但 DGD 或其载体处理后的真皮厚度增加相似。处理后的打孔活检孔的横截面积增加相似。
暴露于 DGD 会导致烧伤焦痂迅速溶解。暴露于 DGD 的正常皮肤或未烧伤真皮没有任何影响,证明其对焦痂的选择性。