Saleh Karim, Strömdahl Ann-Charlotte, Riesbeck Kristian, Schmidtchen Artur
Division of Dermatology, Department of Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden.
Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.
Front Med (Lausanne). 2019 Jul 12;6:159. doi: 10.3389/fmed.2019.00159. eCollection 2019.
A surgical site infection (SSI) is believed to be the result of an exaggerated inflammatory response. Examine the relationship between clinical status and inflammation biomarkers in full-thickness skin grafting wounds. Twenty patients planned for facial full-thickness skin grafting were enrolled. A week after surgery, all graft wounds were clinically assessed using a 3-step scale for inflammation (low, moderate, high). All wounds were swabbed for routine microbiological analysis and assessment of numbers of aerobic bacteria. Tie-over dressings from all patients were collected and used for wound fluid extraction and subsequent analysis of MMPs, cytokines, and NF-κB inducing activity. Wounds with a high degree of inflammation contained increased total MMP activity ( ≤ 0.05) in their corresponding fluids. Likewise, the level of the cytokines IL-1ß, IL-8, IL-6, TNF-α was analyzed, and particularly IL-1ß was discriminatory for highly inflamed wounds ( ≤ 0.01). Moreover, bacterial loads were increased in highly inflamed wounds compared to wounds with a low degree of inflammation ( ≤ 0.01). NF-κB activation in the monocytic cell line THP-1 was significantly higher when these cells were stimulated by wound fluids with a high degree of inflammation ( ≤ 0.01). Growth of in wounds did not vary between wounds with different degrees of inflammation (chi-square 3.8, = 0.144). Biomarkers analyzed from tie-over dressings correlated to clinical wound healing in full-thickness skin grafting.
手术部位感染（SSI）被认为是过度炎症反应的结果。研究全层皮肤移植伤口的临床状态与炎症生物标志物之间的关系。招募了20名计划进行面部全层皮肤移植的患者。术后一周，使用炎症三步量表（低、中、高）对所有移植伤口进行临床评估。对所有伤口进行拭子采样，用于常规微生物分析和需氧菌数量评估。收集所有患者的包扎敷料，用于伤口液体提取以及随后对基质金属蛋白酶（MMPs）、细胞因子和核因子κB（NF-κB）诱导活性的分析。炎症程度高的伤口在其相应液体中的总MMP活性增加（P≤0.05）。同样，对细胞因子白细胞介素-1β（IL-1ß）、白细胞介素-8（IL-8）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的水平进行了分析，特别是IL-1ß对高度发炎的伤口具有鉴别意义（P≤0.01）。此外，与炎症程度低的伤口相比，高度发炎的伤口中的细菌载量增加（P≤0.01）。当单核细胞系THP-1受到高度发炎的伤口液体刺激时，其NF-κB激活明显更高（P≤0.01）。不同炎症程度的伤口中金黄色葡萄球菌的生长没有差异（卡方值3.8，P = 0.144）。从包扎敷料中分析的生物标志物与全层皮肤移植中的临床伤口愈合相关。
