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抗菌溶液治疗血管移植物补丁感染性外科伤口的疗效:大鼠实验研究。

Efficacy of Antiseptic Solutions in Treatment of Infected Surgical Wounds with Patches of Vascular Graft: An Experimental Study in Rats.

机构信息

Vilnius University Faculty of Medicine, Vilnius, LT-03101, Lithuania.

National Center of Pathology, affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, LT-08406, Lithuania.

出版信息

Medicina (Kaunas). 2019 Apr 15;55(4):106. doi: 10.3390/medicina55040106.

Abstract

Treatment of a prosthetic vascular graft infection (PVGI) remains a challenging problem in vascular surgery. The aim of this study was to design a novel rat model for treatment of peripheral vascular prosthesis infection caused by and to determine the efficacy of different antiseptic solutions in suppressing or eradicating infection from the wound and the graft material itself. A piece of Dacron vascular prosthesis was surgically implanted at the dorsum of 48 Wistar rats and the wounds were infected with 5 McFarland standard inoculum of . Suppurating wounds were daily irrigated with different antiseptic solutions: octenidine dihydrochloride, povidone-iodine, chlorhexidine digluconate, and sterile saline. The antimicrobial action of antiseptics was defined according to their capability to eradicate bacteria from the graft surroundings and bacteriological examination of the graft itself. Extended studies on wound microbiology, cytology, and histopathology were performed with an additional group of 10 rats, treated with the most effective antiseptic-octenidine dihydrochloride. Four-day treatment course with octenidine, povidone-iodine, and chlorhexidine resulted in 99.98% ( = 0.0005), 90.73% ( = 0.002), and 65.97% ( = 0.004) decrease in colonies in wound washouts, respectively. The number of colonies increased insignificantly by 19.72% ( = 0.765) in control group. Seven-day treatment course with octenidine eradicated viable bacteria from nine out of 10 wound washouts and sterilized one vascular graft. : A reproducible rat model of PVGI with a thriving infection was designed. It is a first PVGI animal model where different antiseptic solutions were applied as daily irrigations to treat peripheral PVGI. Seven-day treatment with octenidine eradicated bacteria from the wound washouts for 90% of rats and one vascular graft. Further studies are needed to investigate if irrigations with octenidine could properly cure vascular bed from infection to assure a successful implantation of a new synthetic vascular substitute.

摘要

治疗人工血管移植物感染(PVGI)仍然是血管外科学中的一个具有挑战性的问题。本研究旨在设计一种新型大鼠模型,用于治疗 引起的外周血管假体感染,并确定不同防腐剂溶液在抑制或消除伤口和移植物材料本身感染方面的疗效。将一段 Dacron 血管移植物通过手术植入 48 只 Wistar 大鼠的背部,然后用 5 McFarland 标准接种物的 感染伤口。化脓性伤口每天用不同的防腐剂溶液冲洗:奥替尼定二盐酸盐、聚维酮碘、葡萄糖酸氯己定和无菌生理盐水。根据防腐剂从移植物周围消除细菌的能力来定义其抗菌作用,并对移植物本身进行细菌学检查。用另外 10 只大鼠进行了伤口微生物学、细胞学和组织病理学的扩展研究,用最有效的防腐剂-奥替尼定二盐酸盐进行了治疗。奥替尼定、聚维酮碘和葡萄糖酸氯己定的 4 天治疗疗程分别导致伤口冲洗液中 的菌落减少 99.98%( = 0.0005)、90.73%( = 0.002)和 65.97%( = 0.004)。对照组的菌落数仅增加 19.72%( = 0.765)。奥替尼定的 7 天治疗疗程从 10 只大鼠中的 9 只伤口冲洗液中消除了活菌,并使 1 个血管移植物无菌。结论:设计了一种具有活跃 感染的可重现的大鼠 PVGI 模型。这是第一个应用不同防腐剂溶液作为每日冲洗液治疗外周 PVGI 的 PVGI 动物模型。奥替尼定 7 天治疗可使 90%的大鼠和 1 个血管移植物的伤口冲洗液中的细菌消失。需要进一步研究冲洗奥替尼定是否可以从感染中适当治愈血管床,以确保新的合成血管替代品的成功植入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d203/6524009/86b328417d01/medicina-55-00106-g001.jpg

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