Boston, Mass.; and Helsinki and Espoo, Finland.
From the Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School; the Faculty of Medicine, Department of Pharmacology, and the Department of Pathology, Haartman Institute, University of Helsinki; UPM-Kymmene Corp.; and the Helsinki Burn Centre, Töölö Hospital, Helsinki University Hospital.
Plast Reconstr Surg. 2018 Mar;141(3):357e-366e. doi: 10.1097/PRS.0000000000004168.
Although wound contraction is an essential part of healing, excessive contraction can compromise healing through induction of scarring and fibrosis. This in turn leads to development of wound contractures that limit elasticity and function. Major research efforts have focused on development of novel therapeutic approaches to gain inhibitory control over wound contraction. Despite these efforts, the need for cost-effective, clinically feasible, and effective agents to inhibit wound contraction remains.
In this study, the authors investigated the effect of nanofibrillar cellulose hydrogel on wound contraction both in vitro and in vivo. Two different porcine full-thickness wounds (8-mm punch-biopsy wounds and 4 × 4-cm wounds covered with a 1:3-meshed split-thickness skin graft) were treated with or without nanofibrillar cellulose or carboxymethylcellulose (Purilon hydrogel), which was used as a reference treatment. Wound contraction was observed macroscopically, and histologic sections were taken at 14-day follow-up.
Nanofibrillar cellulose hydrogel inhibited 70 percent of punch-biopsy wound contraction, whereas the carboxymethylcellulose hydrogel was ineffective. Importantly, application of nanofibrillar cellulose on split-thickness skin grafts did not inhibit epithelialization of the interstices or cell migration from the graft.
The authors' results, although preliminary, indicate a potential for nanofibrillar cellulose hydrogel as a novel material for controlling excessive wound contraction.
尽管伤口收缩是愈合的重要组成部分，但过度收缩会通过诱导瘢痕和纤维化来损害愈合。这反过来又导致了伤口挛缩的发展，限制了弹性和功能。主要的研究工作集中在开发新的治疗方法上，以获得对伤口收缩的抑制控制。尽管做出了这些努力，但仍需要经济实惠、临床可行且有效的药物来抑制伤口收缩。
在这项研究中，作者研究了纳米纤维纤维素水凝胶对体外和体内伤口收缩的影响。两种不同的猪全层伤口（8mm 打孔活检伤口和 4×4cm 伤口，覆盖 1:3 网眼的分层皮肤移植物）分别用纳米纤维纤维素或羧甲基纤维素（Purilon 水凝胶）处理，后者用作参考治疗。观察伤口收缩的宏观表现，并在 14 天随访时取组织学切片。
纳米纤维纤维素水凝胶抑制了 70%的打孔活检伤口收缩，而羧甲基纤维素水凝胶则无效。重要的是，纳米纤维纤维素在分层皮移植物上的应用并没有抑制间隙的上皮化或细胞从移植物的迁移。
尽管作者的结果是初步的，但表明纳米纤维纤维素水凝胶作为一种控制过度伤口收缩的新型材料具有潜力。
