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光动力疗法和富血小板血浆对金黄色葡萄球菌感染的皮肤放射性溃疡愈合的影响。

THE EFFECT OF PHOTODYNAMIC THERAPY AND PLATELET-ENRICHED PLASMA ON THE HEALING OF SKIN RADIATION ULCERS INFECTED BY STAPHYLOCOCCUS AUREUS.

机构信息

State Institution «Institute of Medical Radiology and Oncology named by S.P. Grigoriev National Academy of Medical Sciences of Ukraine», 82, Pushkinska St., Kharkiv, 61024, Ukraine.

Kharkiv National Medical University, Nauky Ave., 4, Kharkiv, 61022, Ukraine.

出版信息

Probl Radiac Med Radiobiol. 2020 Dec;25:338-352. doi: 10.33145/2304-8336-2020-25-338-352.

DOI:10.33145/2304-8336-2020-25-338-352
PMID:33361845
Abstract

OBJECTIVE

To determine in experiment the quality of healing of skin radiation ulcers infected with Staphylococcusaureus (S. aureus) under the photodynamic therapy (PDT) administration and the use of platelet-rich plasma (PRP).

MATERIALS AND METHODS

The experiment was performed on 95 male WAG rats of 6 months of age, which were divided into three groups. Group 1 included animals in whom a skin radiation ulcers in the thigh area was simulated, followed by application of a 0.2 ml suspension of reference strain of S. aureus to its surface on the 7th day after irradiation. Group 2 included animals with S. aureus-infected skin radiation ulcers, in whom the PET was administered aday after infection contamination. Group 3 included animals with S. aureus-infected skin radiation ulcers, in whomthe PDT was administered a day after infection in the morning, and the PRP was manifold injected in periwound areain the afternoon. The skin with underlying soft tissues from the area of radiation damage were the material for morphological examination. The hematoxylin and eosin, picrofuxin according to van Gizon, Mallory staining wereapplied to micropreparations. A morphometric study was conducted.

RESULTS

In animals with skin radiation ulcers, in whom the PDT was administered upon infection with S. aureus(group 2), compared with animals with simulated infected skin radiation ulcers without treatment (group 1), Theactivation (i.e. accelerating) of the healing occurred for the period from the 14th to the 52nd day of experiment dueto the active processes of wound cleansing from necrotized tissues, less pronounced inflammatory changes in thelesion, and active of appearance and maturation of granulation tissue, less pronounced hemodynamic, ischemic andalternative disorders in the dermis, hypodermis, muscle tissue surrounding the wound cavity, activation of proliferative processes in epithelial layer localized in the marginal parts of the wound. Formation of pathological (hypertrophic or keloid) scar of the skin was the result of healing of skin radiation ulcer infected with S. aureus. In animalswith radiation ulcers infected with S. aureus, in the case of PDT and PRP (group 3) the regenerative process wasdirected not only at accelerating the rate of healing, but also on restoration of original structure of the lost parts ofthe skin compared with only PDT administration (group 2). Acceleration of the healing of the infected skin radiation ulcer in animals of groups 2 and 3 was due to similar processes.

CONCLUSIONS

Photodynamic therapy activates and accelerates the healing process of skin radiation ulcers infectedwith S. aureus and leads to formation of a pathological scar (hypertrophic or keloid). Healing of the infected S. aureusradiation ulcers occurs more actively upon the photodynamic therapy administration in combination with multipleperiwound injections of the platelet-enriched plasma, compared with only photodynamic therapy administration,and finishes with an organotypic regeneration and almost complete skin recovery.

摘要

目的

在实验中确定金黄色葡萄球菌(S. aureus)感染的皮肤放射性溃疡在光动力疗法(PDT)给药和使用富含血小板的血浆(PRP)下的愈合质量。

材料和方法

该实验在 95 只 6 个月大的雄性 WAG 大鼠上进行,将其分为三组。第 1 组包括在大腿区域模拟皮肤放射性溃疡的动物,在照射后第 7 天在其表面应用 0.2ml 参考株 S. aureus 悬浮液。第 2 组包括金黄色葡萄球菌感染的皮肤放射性溃疡动物,其中在感染污染后第 1 天给予 PET。第 3 组包括金黄色葡萄球菌感染的皮肤放射性溃疡动物,其中在上午感染后第 1 天给予 PDT,并在下午多剂量注射伤口周围区域的 PRP。来自放射损伤区域的皮肤和下面的软组织是形态学检查的材料。对微制剂进行了苏木精和曙红、van Gizon 根据 picrofuxin、Mallory 染色。进行了形态计量学研究。

结果

在感染 S. aureus 的皮肤放射性溃疡动物中(第 2 组),与未经治疗的模拟感染皮肤放射性溃疡动物(第 1 组)相比,由于从坏死组织中清除伤口的积极过程、病变中炎症变化不明显、肉芽组织的出现和成熟活跃、真皮、皮下组织中血液动力学、缺血和替代紊乱不明显、伤口腔周围的肌肉组织,上皮层中位于伤口边缘部分的增殖过程被激活。皮肤放射性溃疡感染金黄色葡萄球菌后的愈合结果是病理性(增生性或瘢痕疙瘩性)瘢痕的形成。在感染金黄色葡萄球菌的放射性溃疡动物中,在 PDT 和 PRP (第 3 组)的情况下,再生过程不仅指向愈合速度的加快,而且指向与仅 PDT 给药(第 2 组)相比失去部分皮肤的原始结构的恢复。感染皮肤放射性溃疡动物中愈合的加速是由于类似的过程。

结论

光动力疗法激活并加速金黄色葡萄球菌感染的皮肤放射性溃疡的愈合过程,并导致病理性瘢痕(增生性或瘢痕疙瘩性)的形成。与仅进行光动力疗法相比,在光动力疗法联合多次伤口周围注射富含血小板的血浆给药时,金黄色葡萄球菌感染的放射性溃疡愈合更活跃,并且以器官样再生和几乎完全皮肤恢复结束。

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