Daristotle John L, Lau Lung W, Erdi Metecan, Hunter Joseph, Djoum Albert, Srinivasan Priya, Wu Xiaofang, Basu Mousumi, Ayyub Omar B, Sandler Anthony D, Kofinas Peter
Fischell Department of Bioengineering University of Maryland College Park Maryland.
Sheikh Zayed Institute for Pediatric Surgical Innovation Joseph E. Robert Jr. Center for Surgical Care, Children's National Medical Center Washington District of Columbia.
Bioeng Transl Med. 2019 Dec 13;5(1):e10149. doi: 10.1002/btm2.10149. eCollection 2020 Jan.
Conventional wound dressings are difficult to apply to large total body surface area (TBSA) wounds, as they typically are prefabricated, require a layer of adhesive coating for fixation, and need frequent replacement for entrapped exudate. Large TBSA wounds as well as orthopedic trauma and low-resource surgery also have a high risk of infection. In this report, a sprayable and intrinsically adhesive wound dressing loaded with antimicrobial silver is investigated that provides personalized fabrication with minimal patient contact. The dressing is composed of adhesive and biodegradable poly(lactic--glycolic acid) and poly(ethylene glycol) (PLGA/PEG) blend fibers with or without silver salt (AgNO). in vitro studies demonstrate that the PLGA/PEG/Ag dressing has antimicrobial properties and low cytotoxicity, with antimicrobial silver controllably released over 7-14 days. In a porcine partial-thickness wound model, the wounds treated with both antimicrobial and nonantimicrobial PLGA/PEG dressings heal at rates similar to those of the clinical, thin film polyurethane wound dressing, with similar scarring. However, PLGA/PEG adds a number of features beneficial for wound healing: greater exudate absorption, integration into the wound, a 25% reduction in dressing changes, and tissue regeneration with greater vascularization. There is also modest improvement in epidermis thickness compared to the control wound dressing.
传统伤口敷料难以应用于大面积全身体表面积（TBSA）伤口，因为它们通常是预制的，需要一层粘合剂涂层来固定，并且由于渗出液积聚需要频繁更换。大面积TBSA伤口以及骨科创伤和资源匮乏地区的手术也有很高的感染风险。在本报告中，研究了一种负载抗菌银的可喷涂且具有固有粘性的伤口敷料，该敷料可实现个性化制作，且与患者的接触最少。该敷料由粘性且可生物降解的聚（乳酸-乙醇酸）和聚（乙二醇）（PLGA/PEG）共混纤维组成，含或不含银盐（AgNO）。体外研究表明，PLGA/PEG/Ag敷料具有抗菌特性且细胞毒性低，抗菌银可在7-14天内可控释放。在猪的部分厚度伤口模型中，用抗菌和非抗菌PLGA/PEG敷料治疗的伤口愈合速度与临床使用的薄膜聚氨酯伤口敷料相似，瘢痕形成也相似。然而，PLGA/PEG具有许多有利于伤口愈合的特性：渗出液吸收能力更强、能融入伤口、换药次数减少25%以及组织再生且血管化程度更高。与对照伤口敷料相比，表皮厚度也有适度改善。
