Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Organogenesis Inc., Canton, Massachusetts, USA.
Int Wound J. 2022 Jan;19(1):86-99. doi: 10.1111/iwj.13600. Epub 2021 May 6.
A variety of wound matrix materials that are designed to help heal both acute and chronic wounds are currently available. Because wounds often encounter opportunistic microbes that can delay healing, the effectiveness of these materials is often suboptimal, resulting in delayed or compromised wound healing. The importance of reducing and controlling wound microbes is well recognised and there are several antimicrobial options available to address this unmet clinical need. This study compares the antimicrobial and wound healing capabilities, both in vivo and in vitro against methicillin-resistant Staphylococcus aureus (MRSA) USA 300, for the following compounds: Collagen Wound Matrix-Anti Microbial (CWM-AM); Collagen Wound Matrix-Anti Microbial XT (CWM-AM XT); Antimicrobial Hydrofiber Wound Dressing (AHWD); Dermal Scaffold with Silver (DRSAg); Collagen Extracellular Matrix (CEM); Collagen Wound Matrix (CWM); Matrix Wound Dressing with Silver (MWDAg); Cadexomer Iodine Gel (CIG); Triple Antibiotic Ointment (TAO); and Antimicrobial Wound Gel (AWG). For the in vitro zone of inhibition assay, AWG and CIG had the largest diffused areas, followed by CWM-AM and CWM-AM XT. Furthermore, CWM-AM, CWM-AM XT, AWG, and CIG exhibited a persistent antimicrobial activity for up to 10 days after incubation. However, in the cytotoxicity studies performed using human fibroblasts, CWM-AM and CWM-AM XT had no detrimental effects in cell proliferation and viability, while AWG and CIG were cytotoxic and prohibitive for cell proliferation. Treatments were then assessed for microbiology and wound healing efficacy using an in vivo porcine deep reticular dermal wound model. CWM-AM XT displayed the greatest in vivo antimicrobial activity against MRSA USA300 and expedited the reepithelialisation at a faster rate than other treatment groups. This study shows that a novel collagen matrix containing an antimicrobial agent can reduce the bacterial load and support healing.
目前有多种旨在帮助治疗急性和慢性伤口的创伤基质材料。由于伤口经常会遇到可能会延迟愈合的机会性微生物,因此这些材料的效果往往不理想,导致愈合延迟或受损。减少和控制伤口微生物的重要性已得到充分认识,有几种抗菌选择可用于解决这一未满足的临床需求。本研究比较了以下化合物的抗微生物和伤口愈合能力,包括体内和体外对耐甲氧西林金黄色葡萄球菌(MRSA)美国 300 型的作用:胶原创伤基质-抗微生物(CWM-AM);胶原创伤基质-抗微生物 XT(CWM-AM XT);抗菌水纤维伤口敷料(AHWD);含银真皮支架(DRSAg);胶原细胞外基质(CEM);胶原创伤基质(CWM);含银基质伤口敷料(MWDAg);聚维酮碘凝胶(CIG);三联抗生素软膏(TAO);和抗菌伤口凝胶(AWG)。在体外抑菌试验中,AWG 和 CIG 的扩散面积最大,其次是 CWM-AM 和 CWM-AM XT。此外,CWM-AM、CWM-AM XT、AWG 和 CIG 在孵育后长达 10 天内仍具有持续的抗菌活性。然而,在使用人成纤维细胞进行的细胞毒性研究中,CWM-AM 和 CWM-AM XT 对细胞增殖和活力没有不利影响,而 AWG 和 CIG 则具有细胞毒性,对细胞增殖有抑制作用。然后使用体内猪深网状真皮伤口模型评估了这些治疗方法的微生物学和伤口愈合效果。CWM-AM XT 对 MRSA USA300 表现出最强的体内抗菌活性,并以比其他治疗组更快的速度促进再上皮化。本研究表明,一种含有抗菌剂的新型胶原基质可以减少细菌负荷并支持愈合。