Held Manuel, Medved Fabian, Petersen Wiebke, Tolzmann Dascha Sophie, Rahmanian-Schwarz Afshin, Schaller Hans-Eberhard, Rothenberger Jens
Manuel Held, MD, is a resident; Fabian Medved, MD, is a consultant; Wiebke Petersen, MD, is a resident; Dascha Sophie Tolzmann, MD, is a resident; Hans-Eberhard Schaller, MD, is Department Head; and Jens Rothenberger, MD, is a consultant, all at the BG-Trauma Center, Department of Plastic and Hand Surgery, Reconstructive and Aesthetic Surgery, Eberhard Karls University, Tuebingen, Germany. Afshin Rahmanian-Schwarz, MD, is Department Head, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Clinic Traunstein, Traunstein, Bavaria, Germany.
Adv Skin Wound Care. 2017 Nov;30(11):517-521. doi: 10.1097/01.ASW.0000525848.21221.b8.
Innovative skin substitutes and temporary wound dressings are frequently used in the treatment of superficial and partial-thickness wounds. The aim of this study was to compare 2 commonly used temporary skin dressings with a newly developed collagen matrix to determine changes in microcirculation as measured by blood flow, hemoglobin oxygenation, and relative hemoglobin values during healing of partial-thickness skin defects.
This animal study involved 28 adult male Lewis rats. On the back of each rat, 2 standardized partial-thickness skin defects were generated through a skin dermatome (n = 56). Then, wounds were treated with polylactide-based copolymer skin substitute (Suprathel, PolyMedics, Denkendorf, Germany; n = 14), biosynthetic skin dressing (Biobrane, Smith & Nephew, Hamburg, Germany; n = 14), or Collagen Cell Carrier (CCC; Naturin Viscofan, Weinheim, Germany; n = 14). The remaining control wounds were left untreated (n = 14).
Perfusion dynamics were assessed every 10 days for 80 days with the O2C device (LEA Medizintechnik, Gieβen, Germany) to determine blood flow, hemoglobin oxygenation, and relative amount of hemoglobin.
Blood flow was increased in all wounds for at least 30 days after wound generation. The relative amounts of hemoglobin were increased in superficial layers (2 mm) for 10 to 20 days. Hemoglobin oxygenation in the superficial layers decreased in the polylactide-based copolymer skin substitute and biosynthetic skin dressing-treated groups and initially increased in the untreated wounds and CCC groups on day 10; these values also decreased.
The presented results demonstrate the complex changes in microcirculation in the course of healing partial-thickness wounds with different wound dressings and contribute to a better understanding of these wounds. However, based on the results of the study, a clear recommendation for a specific substitute is not yet possible.
创新型皮肤替代物和临时性伤口敷料常用于治疗浅表及部分厚度伤口。本研究旨在比较两种常用的临时性皮肤敷料与一种新开发的胶原蛋白基质，以确定在部分厚度皮肤缺损愈合过程中，通过血流、血红蛋白氧合及相对血红蛋白值测量的微循环变化。
本动物研究涉及28只成年雄性Lewis大鼠。在每只大鼠背部，通过皮肤刀制造2个标准化的部分厚度皮肤缺损（n = 56）。然后，伤口分别用聚丙交酯基共聚物皮肤替代物（Suprathel，PolyMedics，德国登肯多夫；n = 14）、生物合成皮肤敷料（Biobrane，施乐辉，德国汉堡；n = 14）或胶原蛋白细胞载体（CCC；Naturin Viscofan，德国魏因海姆；n = 14）进行处理。其余对照伤口不做处理（n = 14）。
使用O2C设备（德国吉森LEA Medizintechnik公司）在80天内每隔10天评估灌注动力学，以确定血流、血红蛋白氧合及血红蛋白相对含量。
伤口产生后至少30天内，所有伤口的血流均增加。表层（2毫米）血红蛋白相对含量在10至20天内增加。聚丙交酯基共聚物皮肤替代物和生物合成皮肤敷料处理组的表层血红蛋白氧合下降，未处理伤口和CCC组在第10天最初增加，随后这些值也下降。
本研究结果表明，使用不同伤口敷料愈合部分厚度伤口过程中微循环存在复杂变化，有助于更好地理解这些伤口。然而，基于本研究结果，目前尚无法对特定替代品给出明确推荐。
