Criss C N, Gao Y, De Silva G, Yang J, Anderson J M, Novitsky Y W, Soltanian H, Rosen M J
Case Comprehensive Hernia Center, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA,
Hernia. 2015 Aug;19(4):645-50. doi: 10.1007/s10029-014-1241-9. Epub 2014 Apr 13.
Losartan, a commonly used angiotensin II receptor blocker (ARB) for blood pressure control, also impairs cutaneous wound healing. Our current study will analyze how Losartan affects wound healing in the muscle and fascia from both biomechanical and histological aspects.
A total of 26 Sprague-Dawley rats were separated into one control group (NS, N = 13) and one experimental group (LG, N = 13) to receive normal saline and 40 mg/kg of Losartan by way of gastric lavage, respectively. 7 days later, all animals were subjected to a 5 cm midline laparotomy. The fascia and skin were then closed with 4-0 prolene and 5-0 vicryl. 15 days postoperatively, the animals were sacrificed and the abdominal wall harvested for wound tensiometric test and histological analysis.
All 26 rats survived to the time of necropsy. Tensiometry detected significantly higher wound tensile strength in the NS group (1.6 ± 0.31 N/mm) than in the LG (1.3 ± 0.28 N/mm) group (p = 0.016). Transection histology with trichrome staining demonstrated higher degree of immature fibroplasia inside the wound in the LG group than in the NS group (p = <0.0001). The LG group also had larger incisional gaps than the NG group.
The antihypertensive drug, Losartan, retards wound healing in the abdominal fascia and reduces wound tensile strength in our rat model. Attention should be paid to the potential effects of various medications on fascial wound healing to guarantee optimal surgical outcomes.
氯沙坦是一种常用的用于控制血压的血管紧张素II受体阻滞剂（ARB），它也会损害皮肤伤口愈合。我们目前的研究将从生物力学和组织学方面分析氯沙坦如何影响肌肉和筋膜的伤口愈合。
将总共26只Sprague-Dawley大鼠分为一个对照组（NS，N = 13）和一个实验组（LG，N = 13），分别通过灌胃给予生理盐水和40mg/kg氯沙坦。7天后，对所有动物进行5cm中线剖腹手术。然后用4-0普理灵和5-0薇乔缝合筋膜和皮肤。术后15天，处死动物并采集腹壁进行伤口张力测试和组织学分析。
所有26只大鼠均存活至尸检时。张力测定法检测到NS组（1.6±0.31N/mm）的伤口抗张强度明显高于LG组（1.3±0.28N/mm）（p = 0.016）。三色染色的横断组织学显示，LG组伤口内未成熟纤维增生程度高于NS组（p =<0.0001）。LG组的切口间隙也比NG组大。
在我们的大鼠模型中，抗高血压药物氯沙坦会延缓腹部筋膜的伤口愈合并降低伤口抗张强度。应注意各种药物对筋膜伤口愈合的潜在影响，以确保最佳手术效果。
