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磺胺嘧啶银乳膏、三联抗菌软膏或高渗纳米乳剂局部应用对包扎的马全层皮肤伤口愈合、细菌载量及过度增生肉芽组织形成的影响

Effects of topical application of silver sulfadiazine cream, triple antimicrobial ointment, or hyperosmolar nanoemulsion on wound healing, bacterial load, and exuberant granulation tissue formation in bandaged full-thickness equine skin wounds.

作者信息

Harmon Caroline C Gillespie, Hawkins Jan F, Li Jianming, Connell Sean, Miller Margaret, Saenger Megan, Freeman Lynetta J

出版信息

Am J Vet Res. 2017 May;78(5):638-646. doi: 10.2460/ajvr.78.5.638.

Abstract

OBJECTIVE To determine the effects of 3 topically applied treatments (1% silver sulfadiazine cream [SSC], triple antimicrobial ointment [TAO], and hyperosmolar nanoemulsion [HNE]) on microbial counts, exuberant granulation tissue (EGT) development, and reepithelialization of contaminated wounds at the distal aspect of the limbs of horses. ANIMALS 8 healthy adult horses. PROCEDURES A 2.5 × 2.5-cm, full-thickness, cutaneous wound was created at the dorsal aspect of each metacarpus and metatarsus (1 wound/limb/horse), covered with nonadhesive dressing, and bandaged. Wounds were inoculated with bacteria and fungi the next day. Each wound on a given horse was randomly assigned to 1 of 4 treatment groups (SSC, TAO, HNE, or no topical treatment [control]). Bandage changes, culture of wound samples, treatments, photography for wound measurements, and biopsy were performed at predetermined time points. Time (days) until wound closure, number of EGT excisions, microbial counts, and scores for selected histologic characteristics were compared among groups. RESULTS Median time to wound closure for all groups was 42 days. Time to wound closure and histologic characteristics of wound healing did not differ among groups. Least squares mean microbial counts were significantly higher for HNE-treated wounds on days 9 and 21, compared with SSC-treated and TAO-treated wounds, but not controls. Proportions of SSC-treated (7/8) or HNE-treated (5/8) wounds needing EGT excision were significantly greater than that of TAO-treated (1/8) wounds. The proportion of SSC-treated wounds with EGT excision was greater than that of controls (3/8). CONCLUSIONS AND CLINICAL RELEVANCE None of the treatments resulted in more rapid wound closure, compared with that for untreated control wounds under the study conditions. When treatment is warranted, TAO may help to limit EGT formation.

摘要

目的 确定3种局部应用治疗方法(1%磺胺嘧啶银乳膏[SSC]、三联抗菌软膏[TAO]和高渗纳米乳剂[HNE])对马四肢远端污染伤口的微生物计数、过度增生性肉芽组织(EGT)形成及再上皮化的影响。

动物 8匹健康成年马。

方法 在每匹马的掌骨和跖骨背侧制造一个2.5×2.5 cm的全层皮肤伤口(每匹马每个肢体1个伤口),覆盖非粘性敷料并包扎。次日对伤口接种细菌和真菌。将每匹马身上的每个伤口随机分配至4个治疗组之一(SSC、TAO、HNE或不进行局部治疗[对照组])。在预定时间点进行绷带更换、伤口样本培养、治疗、伤口测量摄影及活检。比较各组直至伤口闭合的时间(天)、EGT切除次数、微生物计数及选定组织学特征的评分。

结果 所有组伤口闭合的中位时间为42天。各组伤口闭合时间及伤口愈合的组织学特征无差异。与SSC治疗组和TAO治疗组伤口相比,HNE治疗组伤口在第9天和第21天的最小二乘平均微生物计数显著更高,但与对照组相比无差异。需要切除EGT的SSC治疗组(7/8)或HNE治疗组(5/8)伤口的比例显著高于TAO治疗组(1/8)伤口。SSC治疗组需要切除EGT的伤口比例高于对照组(3/8)。

结论及临床意义 在本研究条件下,与未治疗的对照伤口相比,没有一种治疗方法能使伤口更快闭合。如需治疗,TAO可能有助于限制EGT形成。

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