Larsen Heidi F, Ahlström Malin G, Gjerdrum Lise M R, Mogensen Mette, Ghathian Khaled, Calum Henrik, Sørensen Anne L, Forman Julie L, Vandeven Mark, Holerca Marian N, Du-Thumm Laurence, Jorgensen Lars N, Ågren Magnus S
Department of Dermatology and Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Pathology, Zealand University Hospital, Roskilde, Denmark.
Wound Repair Regen. 2017 Nov;25(6):984-993. doi: 10.1111/wrr.12605. Epub 2018 Feb 16.
We explored use of the suction-blister wound model in the assessment of not only epidermal regeneration but also pain, the microvascular response and bacteriology. The effects of topical zinc sulfate were studied to articulate the methodologies in this double-blind trial. One epidermal suction blister (10 mm) was induced on each buttock in 30 healthy volunteers (15 females:15 males) and deroofed on day 0. The wounds were randomized to daily treatment with 1.4% zinc sulfate shower gel (n = 20), placebo (n = 20) or control (n = 20). Digital photography coupled with planimetry, transepidermal water loss (TEWL) measurement and optical coherence tomography (OCT) was benchmarked to the gold standard of histology of 60 full-thickness wound biopsies on day 4. Pain increased after application of the shower gels. Microvessel density, determined from OCT images, increased from day 0 to day 2 in the three groups but increased more with the placebo than with the zinc shower gel (p = 0.003) or the control treatment (p = 0.002) and correlated (r = 0.313, p = 0.015) with the inflammatory response on day 4, as determined by histology. Coagulase-negative staphylococci were more common in wounds compared with skin (p = 0.002) and was reduced (p = 0.030) with zinc sulfate treatment. Planimetric analysis of digital wound images was not biased (p = 0.234) compared with histology, and TEWL measurements showed no correlation (r = 0.052, p = 0.691) with epithelialization. Neoepidermal formation, determined by histology, did not differ (p = 0.290) among the groups. Zinc sulfate reduced (p = 0.031) the release of lactate dehydrogenase from cultured gel-treated keratinocytes isolated from the blister roofs. Therefore, combination of the standardized suction-blister wound model with noninvasive planimetry and OCT is a useful tool for assessing wound therapies. Zinc sulfate transiently dampened inflammation and reduced bacterial growth.
我们探讨了使用抽吸性水疱伤口模型不仅用于评估表皮再生，还用于评估疼痛、微血管反应和细菌学。在这项双盲试验中，研究了局部应用硫酸锌的效果以阐明相关方法。在30名健康志愿者（15名女性：15名男性）的每个臀部诱导形成一个表皮抽吸性水疱（10毫米），并在第0天去除疱顶。将伤口随机分为每日用1.4%硫酸锌沐浴露治疗组（n = 20）、安慰剂组（n = 20）或对照组（n = 20）。在第4天，将数字摄影结合面积测量、经表皮水分流失（TEWL）测量和光学相干断层扫描（OCT）与60个全层伤口活检组织学的金标准进行对比。应用沐浴露后疼痛增加。从OCT图像确定的微血管密度在三组中从第0天到第2天均增加，但安慰剂组比硫酸锌沐浴露组（p = 0.003）或对照治疗组（p = 0.002）增加得更多，并且与第4天组织学确定的炎症反应相关（r = 0.313，p = 0.015）。与皮肤相比，凝固酶阴性葡萄球菌在伤口中更常见（p = 0.002），而硫酸锌治疗可使其减少（p = 0.030）。与组织学相比，数字伤口图像的面积分析无偏差（p = 0.234），并且TEWL测量与上皮形成无相关性（r = 0.052，p = 0.691）。组织学确定的新表皮形成在各组之间无差异（p = 0.290）。硫酸锌减少了（p = 0.031）从水疱顶部分离的经凝胶处理的培养角质形成细胞中乳酸脱氢酶的释放。因此，标准化的抽吸性水疱伤口模型与非侵入性面积测量和OCT相结合是评估伤口治疗的有用工具。硫酸锌可暂时减轻炎症并减少细菌生长。
