Menclová Katerina, Svoboda Petr, Hadač Jan, Juhás Štefan, Juhásová Jana, Pejchal Jaroslav, Mandys Václav, Eminger Karel, Ryska Miroslav
Department of Surgery, 2nd Faculty of Medicine, Military University Hospital Prague and Charles University, Prague 169 02, Czechia.
Institute of Animal Physiology and Genetics of the Academy of Sciences CR, Lib ěchov 277 21, Czechia.
Mil Med. 2023 Jan 4;188(1-2):e133-e139. doi: 10.1093/milmed/usab155.
Nanofiber wound dressings remain the domain of in vitro studies. The purpose of our study was to verify the benefits of chitosan (CTS) and polylactide (PLA)-based nanofiber wound dressings on a porcine model of a naturally contaminated standardized wound and compare them with the conventional dressings, i.e., gauze and Inadine.
The study group included 32 pigs randomized into four homogeneous groups according to the wound dressing type. Standardized wounds were created on their backs, and wound dressings were regularly changed. We evaluated difficulty of handling individual dressing materials and macroscopic appearance of the wounds. Wound swabs were taken for bacteriological examination. Blood samples were obtained to determine blood count values and serum levels of acute phase proteins (serum amyloid A, C-reactive protein, and haptoglobin). The crucial point of the study was histological analysis. Microscopic evaluation was focused on the defect depth and tissue reactions, including formation of the fibrin exudate with neutrophil granulocytes, the layer of granulation and cellular connective tissue, and the reepithelialization. Statistical analysis was performed by using SPSS software. The analysis was based on the Kruskal-Wallis H test and Mann-Whitney U test followed by Bonferroni correction. Significance was set at P < .05.
Macroscopic examination did not show any difference in wound healing among the groups. However, evaluation of histological findings demonstrated that PLA-based nanofiber dressing accelerated the proliferative (P = .025) and reepithelialization (P < .001) healing phases, while chitosan-based nanofiber dressing potentiated and accelerated the inflammatory phase (P = .006). No statistically significant changes were observed in the blood count or acute inflammatory phase proteins during the trial. Different dynamics were noted in serum amyloid A values in the group treated with PLA-based nanofiber dressing (P = .006).
Based on the microscopic examination, we have documented a positive effect of nanofiber wound dressings on acceleration of individual phases of the healing process. Nanofiber wound dressings have a potential to become in future part of the common wound care practice.
纳米纤维伤口敷料仍主要用于体外研究。我们研究的目的是在自然污染的标准化伤口猪模型上验证基于壳聚糖(CTS)和聚乳酸(PLA)的纳米纤维伤口敷料的益处,并将它们与传统敷料,即纱布和碘附进行比较。
研究组包括32头猪,根据伤口敷料类型随机分为四个同质组。在它们的背部创建标准化伤口,并定期更换伤口敷料。我们评估了处理每种敷料材料的难度以及伤口的宏观外观。采集伤口拭子进行细菌学检查。采集血样以确定血细胞计数和急性期蛋白(血清淀粉样蛋白A、C反应蛋白和触珠蛋白)的血清水平。该研究的关键点是组织学分析。显微镜评估集中在缺损深度和组织反应,包括纤维蛋白渗出物与中性粒细胞的形成、肉芽层和细胞结缔组织以及再上皮化。使用SPSS软件进行统计分析。分析基于Kruskal-Wallis H检验和Mann-Whitney U检验,随后进行Bonferroni校正。显著性设定为P < 0.05。
宏观检查未显示各组间伤口愈合有任何差异。然而,组织学结果评估表明,基于PLA的纳米纤维敷料加速了增殖期(P = 0.025)和再上皮化期(P < 0.001)的愈合,而基于壳聚糖的纳米纤维敷料增强并加速了炎症期(P = 0.006)。试验期间血细胞计数或急性炎症期蛋白未观察到统计学上的显著变化。在用基于PLA的纳米纤维敷料治疗的组中,血清淀粉样蛋白A值出现了不同的变化趋势(P = 0.006)。
基于显微镜检查,我们记录了纳米纤维伤口敷料对加速愈合过程各阶段的积极作用。纳米纤维伤口敷料未来有可能成为常见伤口护理实践的一部分。