Liu Y F, Jiang Z Q, Huang Y, Ni P W, Xie T
Wound Healing Centre, Emergency Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022 Jul 20;38(7):650-660. doi: 10.3760/cma.j.cn501120-20210401-00113.
To explore the feasibility on the preparation of novel negative pressure materials for constructing new matrix of full-thickness skin defect wounds in rats. The experimental research method was applied. The microstructure of polyurethane foam dressing which was commonly used in negative pressure treatment was observed under scanning electron microscope, and its pore diameter was detected (=5). Polycaprolactone (PCL) and polybutylene succinate (PBS) were used respectively as raw materials for the preparation of PCL and PBS negative pressure materials by melt spinning technology, with the measured pore diameter of polyurethane foam dressing as the spinning spacing at the spinning rates of 15, 25, and 35 mm/s, respectively. The microstructures of the prepared negative pressure materials were observed under scanning electron microscope, and their fiber diameters were measured. The tensile strength and tensile modulus of the prepared negative pressure materials and polyurethane foam dressing were measured by tensile testing machine and composite testing machine, respectively (=5), to screen the spinning rate for subsequent preparation of negative pressure materials. Human skin fibroblasts (Fbs) in logarithmic growth phase were co-cultured with PCL negative pressure material and PBS negative pressure material prepared at the selected spinning rate, respectively. After 1, 4, and 7 day (s) of co-culture, the cell activity and adhesion in the materials was detected by living/dead cells detection kit, and the cell proliferation level in the materials was detected by cell counting kit 8 method (=5). A full-thickness skin defect wound was prepared on the back of 18 5-6 weeks old Sprague-Dawley rats (gender unlimited). Immediately after injury, the injured rats were divided into PCL+polyurethane group, PBS+polyurethane group, and polyurethane alone group according to the random number table (with 6 rats in each group). The wounds were covered with materials containing corresponding component and performed with continuous negative pressure suction at the negative pressure of -16.7 kPa. The wound tissue along with materials directly contacted to the wound (hereinafter referred to as wound specimens) were collected from 3 rats in each group after 7 and 14 days of negative pressure treatment (NPT), respectively. The growth of granulation tissue and the attachment of material to wound surface were observed after hematoxylin-eosin staining, the collagen fiber deposition was observed after Masson staining, and CD34 and interleukin-6 (IL-6) positive cells were detected and counted by immunohistochemical staining. Data were statistically analyzed with one-way analysis of variance, analysis of variance for factorial design, least significant difference- test, Kruskal-Wallis test, Mann-Whitney test, and Bonferroni correction. The microstructure of polyurethane foam dressing was loose and porous, with the pore diameter of (815±182) μm. The spinning spacing for the subsequent negative pressure material was set as 800 μm. The microstructures of PBS negative pressure material and PCL negative pressure material were regular, with vertically interconnected layers and continuous fibers in even thickness, but the fibers of PBS negative pressure material were straighter than those of PCL negative pressure material. There was no obvious difference in the microstructure of negative pressure materials prepared from the same raw material at different spinning rates. The fiber diameters of PCL negative pressure materials prepared at three spinning rates were similar (>0.05). The fiber diameters of PBS negative pressure materials prepared at spinning rates of 25 mm/s and 35 mm/s were significantly smaller than the fiber diameter of PBS negative pressure material prepared at the spinning rate of 15 mm/s (with values of 4.99 and 6.40, respectively, <0.01). Both the tensile strength and tensile modulus of PCL negative pressure materials prepared at three spinning rates were similar (>0.05). The tensile strength of PBS negative pressure materials prepared at spinning rates of 15 mm/s and 25 mm/s was significantly lower than that of PBS negative pressure materials prepared at the spinning rate of 35 mm/s (with values of 9.20 and 8.92, respectively, <0.01), and the tensile modulus was significantly lower than that of PBS negative pressure materials prepared at the spinning rate of 35 mm/s (with values of 2.58 and 2.47, respectively, <0.05). Subsequently, PCL negative pressure material was prepared at the spinning rate of 35 mm/s, and PBS negative pressure material was prepared at the spinning rate of 15 mm/s. After 1, 4, and 7 day (s) of co-culture, the number of human skin Fbs that adhered to PCL negative pressure material and PBS negative pressure material increased with time, and there was no significant difference between the two materials. After 1 and 7 day (s) of co-culture, the proliferation levels of human skin Fbs between the two negative pressure materials were similar (>0.05). After being co-cultured for 4 days, the proliferation level of human skin Fbs in PBS negative pressure material was significantly higher than that in PCL negative pressure material (=6.37, <0.01). After 7 days of NPT, the materials were clearly identifiable and a small amount of collagen fibers were also observed in the wound specimens of rats in the three groups; a small amount of granulation tissue was observed in the wound specimens of rats in polyurethane alone group. After 14 days of NPT, a large number of granulation tissue and collagen fibers were observed in the wound specimens of rats in the three groups; the materials and wound tissue in the wound specimens of rats in PCL+polyurethane group could not be clearly distinguished. After 7 and 14 days of NPT, the collagen fibers in the wound specimens of rats in polyurethane alone group were denser than those in the other two groups. After 7 days of NPT, the number of CD34 positive cells in the wound specimens of rats in PBS+polyurethane group was 14.8±3.6 per 400 times visual field, which was significantly less than 27.8±9.1 in polyurethane alone group (=3.06, <0.05); the number of IL-6 positive cells was 60 (49, 72), which was significantly more than 44 (38, 50) in polyurethane alone group (=2.41, <0.05). After 14 days of NPT, the number of IL-6 positive cells in the wound specimens of rats in PBS+polyurethane group was 19 (12, 28) per 400 times visual field, which was significantly more than 3 (1, 10) in PCL+polyurethane group and 9 (2, 13) in polyurethane alone group (with values of 2.61 and 2.40, respectively, <0.05). The prepared PCL negative pressure material and PBS negative pressure material have good biocompatibility, and can successfully construct the new matrix of full-thickness skin defect wounds in rats. PCL negative pressure material is better than PBS negative pressure material in general.
探讨制备新型负压材料用于构建大鼠全层皮肤缺损创面新基质的可行性。采用实验研究方法。在扫描电子显微镜下观察负压治疗中常用的聚氨酯泡沫敷料的微观结构,并检测其孔径((n = 5))。分别以聚己内酯(PCL)和聚丁二酸丁二醇酯(PBS)为原料,通过熔融纺丝技术制备PCL和PBS负压材料,以测得的聚氨酯泡沫敷料孔径作为纺丝间距,纺丝速度分别为15、25和35 mm/s。在扫描电子显微镜下观察制备的负压材料的微观结构,并测量其纤维直径。分别用拉伸试验机和复合试验机测量制备的负压材料和聚氨酯泡沫敷料的拉伸强度和拉伸模量((n = 5)),以筛选后续制备负压材料的纺丝速度。将对数生长期的人皮肤成纤维细胞(Fbs)分别与以选定纺丝速度制备的PCL负压材料和PBS负压材料共培养。共培养1、4和7天后,用活/死细胞检测试剂盒检测材料中细胞的活性和黏附情况,用细胞计数试剂盒8法检测材料中细胞的增殖水平((n = 5))。在18只5 - 6周龄的Sprague-Dawley大鼠(性别不限)背部制备全层皮肤缺损创面。受伤后立即根据随机数字表将受伤大鼠分为PCL + 聚氨酯组、PBS + 聚氨酯组和单纯聚氨酯组(每组6只大鼠)。用含相应成分的材料覆盖创面,并在 - 16.7 kPa的负压下进行持续负压吸引。负压治疗(NPT)7天和14天后,分别从每组3只大鼠中收集与创面直接接触的创面组织及材料(以下简称创面标本)。苏木精 - 伊红染色后观察肉芽组织生长及材料与创面表面的附着情况,Masson染色后观察胶原纤维沉积情况,免疫组化染色检测并计数CD34和白细胞介素 - 6(IL - 6)阳性细胞。数据采用单因素方差分析、析因设计方差分析、最小显著差检验、Kruskal - Wallis检验、Mann - Whitney检验和Bonferroni校正进行统计学分析。聚氨酯泡沫敷料的微观结构疏松多孔,孔径为(815 ± 182)μm。将后续负压材料的纺丝间距设定为800 μm。PBS负压材料和PCL负压材料的微观结构规则,具有垂直互连的层状结构且纤维连续、厚度均匀,但PBS负压材料的纤维比PCL负压材料的纤维更直。不同纺丝速度下由相同原料制备的负压材料微观结构无明显差异。三种纺丝速度下制备的PCL负压材料的纤维直径相似((P>0.05))。纺丝速度为25 mm/s和35 mm/s时制备的PBS负压材料的纤维直径显著小于纺丝速度为15 mm/s时制备的PBS负压材料的纤维直径((P)值分别为4.99和6.40,均(<0.01))。三种纺丝速度下制备的PCL负压材料的拉伸强度和拉伸模量均相似((P>0.05))。纺丝速度为15 mm/s和25 mm/s时制备的PBS负压材料的拉伸强度显著低于纺丝速度为35 mm/s时制备的PBS负压材料的拉伸强度((P)值分别为9.20和8.92,均(<0.01)),拉伸模量显著低于纺丝速度为35 mm/s时制备的PBS负压材料的拉伸模量((P)值分别为2.58和2.47,均(<0.05))。随后,以35 mm/s的纺丝速度制备PCL负压材料,以15 mm/s的纺丝速度制备PBS负压材料。共培养1、4和7天后,黏附于PCL负压材料和PBS负压材料上的人皮肤Fbs数量随时间增加,两种材料之间无显著差异。共培养1天和7天后,两种负压材料上人皮肤Fbs的增殖水平相似((P>0.05))。共培养4天后,PBS负压材料中人皮肤Fbs的增殖水平显著高于PCL负压材料((P = 6.37),(<0.01))。NPT 7天后,材料清晰可辨,三组大鼠的创面标本中均观察到少量胶原纤维;单纯聚氨酯组大鼠的创面标本中观察到少量肉芽组织。NPT 14天后,三组大鼠的创面标本中均观察到大量肉芽组织和胶原纤维;PCL + 聚氨酯组大鼠的创面标本中材料与创面组织无法清晰区分。NPT 7天和14天后,单纯聚氨酯组大鼠创面标本中的胶原纤维比其他两组更致密。NPT 7天后,PBS + 聚氨酯组大鼠创面标本中每400倍视野下CD34阳性细胞数为14.8 ± 3.6,显著少于单纯聚氨酯组的27.8 ± 9.1((P = 3.06),(<0.05));IL - 6阳性细胞数为60(49,72),显著多于单纯聚氨酯组的44(38,50)((P = 2.41),(<0.05))。NPT 14天后,PBS + 聚氨酯组大鼠创面标本中每400倍视野下IL - 6阳性细胞数为19(12,28),显著多于PCL + 聚氨酯组的3(1,10)和单纯聚氨酯组的9(2,13)((P)值分别为2.61和2.40,均(<0.05))。制备的PCL负压材料和PBS负压材料具有良好的生物相容性,能够成功构建大鼠全层皮肤缺损创面的新基质。总体而言,PCL负压材料优于PBS负压材料。