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局部给药的米诺环素可穿透全层烧伤焦痂并减少组织细菌计数。

Topically Delivered Minocycline Penetrates a Full-Thickness Burn Eschar and Reduces Tissue Bacterial Counts.

作者信息

Yang Lu, Broomhead Michael, Nuutila Kristo, Proppe Karl, Eriksson Elof

机构信息

Applied Tissue Technologies LLC, Hingham, MA.

出版信息

J Burn Care Res. 2018 Aug 17;39(5):790-797. doi: 10.1093/jbcr/irx051.

Abstract

Injuries to the skin are often complicated by invasive infections. Standard treatment with intravenous antibiotics has limited tissue penetration and sometimes, major systemic toxicity. Traditional topical delivery of antimicrobials also has limited effectiveness and duration of action. We demonstrate the use of a new Platform Wound Device (PWD) for delivery of topical, ultrahigh concentrations of minocycline as well as lidocaine onto the burn eschar and on the surface of excisional wounds in a total of 56 burn wounds and 24 excisional wounds in a porcine model. Wounds were created on day 0, debrided on day 3, and pigs were killed on day 7. After 3 days of PWD with minocycline treatment, bacterial count was 5.44 log CFU/g in dorsal wound tissue inoculated with methicillin-resistant Staphylococcus aureus, less than that after treatment with silver sulfadiazine cream (7.64 log CFU/g). Pain was also relieved or eliminated in burn wounds and full-thickness excisional wounds when lidocaine was delivered by the PWD. The results demonstrate that ultrahigh concentrations of antibiotics can be delivered effectively by the PWD, and will accelerate wound bed preparation.

摘要

皮肤损伤常因侵袭性感染而复杂化。静脉注射抗生素的标准治疗方法组织穿透性有限,有时还会产生严重的全身毒性。传统的抗菌药物局部给药效果和作用持续时间也有限。我们展示了一种新型平台伤口装置(PWD)的应用,该装置可将超高浓度的米诺环素以及利多卡因输送到猪模型中的56个烧伤创面和24个切除创面的烧伤焦痂及创面表面。在第0天制造伤口,第3天进行清创,第7天处死猪。用米诺环素进行PWD治疗3天后,接种耐甲氧西林金黄色葡萄球菌的背部伤口组织中的细菌计数为5.44 log CFU/g,低于用磺胺嘧啶银乳膏治疗后的计数(7.64 log CFU/g)。当通过PWD输送利多卡因时,烧伤创面和全层切除创面的疼痛也得到缓解或消除。结果表明,PWD可有效输送超高浓度的抗生素,并将加速伤口床的准备。

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