Research & Development Department, Systagenix, An Acelity Company, Skipton, UK.
Int Wound J. 2017 Dec;14(6):1066-1075. doi: 10.1111/iwj.12761. Epub 2017 May 14.
This study investigated whether there are differences in the ability of wound dressings to modulate certain factors known to affect wound healing. A selection of antimicrobial dressings (AQUACEL Ag Extra , AQUACEL Ag+ Extra , IODOFLEX , ACTICOAT 7 and PROMOGRAN PRISMA matrix) were tested for their effect on both bacterial bioburden and human dermal fibroblasts. Some dressings underwent further evaluation for activity against Pseudomonas aeruginosa biofilms using a colony-drip flow reactor model. The ability of in vitro biofilms to produce proteases, and the effect of PROMOGRAN PRISMA matrix on such proteases, was also investigated. All antimicrobial dressings tested reduced vegetative bacterial load; however, only PROMOGRAN PRISMA matrix was able to significantly reduce biofilm populations (P = 0·01). Additionally, PROMOGRAN PRISMA matrix was the only dressing that did not inhibit dermal fibroblast growth. All other dressings were detrimental to cell viability. In vitro biofilms of Pseudomonas aeruginosa were demonstrated as being capable of releasing bacterial proteases into their surroundings, and incubation with PROMOGRAN PRISMA matrix led to a 77% reduction in activity of such proteases (P = 0·002). The unique ability of PROMOGRAN PRISMA matrix to reduce in vitro vegetative bacteria, biofilm bacteria and bacterial proteases while still allowing dermal fibroblast proliferation may help rebalance the wound environment and reduce the occurrence of infection.
本研究旨在探讨伤口敷料在调节某些已知影响伤口愈合的因素方面的能力是否存在差异。选择了一些抗菌敷料（Aquacel Ag Extra、Aquacel Ag+ Extra、IODOFLEX、Acticoat 7 和 PROMOGRAN PRISMA 基质），以测试它们对细菌生物负荷和人真皮成纤维细胞的影响。一些敷料进一步使用菌落滴落流反应器模型评估了其对铜绿假单胞菌生物膜的活性。还研究了体外生物膜产生蛋白酶的能力以及 PROMOGRAN PRISMA 基质对这些蛋白酶的影响。所有测试的抗菌敷料都减少了营养细菌的负荷；然而，只有 PROMOGRAN PRISMA 基质能够显著减少生物膜种群（P = 0·01）。此外，PROMOGRAN PRISMA 基质是唯一不会抑制真皮成纤维细胞生长的敷料。所有其他敷料都对细胞活力有害。已经证明铜绿假单胞菌的体外生物膜能够将细菌蛋白酶释放到其周围环境中，并且与 PROMOGRAN PRISMA 基质孵育可导致这些蛋白酶的活性降低 77%（P = 0·002）。PROMOGRAN PRISMA 基质独特的能力是能够减少体外营养细菌、生物膜细菌和细菌蛋白酶，同时仍允许真皮成纤维细胞增殖，这可能有助于重新平衡伤口环境并减少感染的发生。
