Division of Basic & Clinical Medicine, Faculty of Nursing, Nagano College of Nursing, Komagane 399-4117, Nagano, Japan.
School of Nursing and Public Health, Yangzhou University, Yangzhou 225000, China.
Int J Mol Sci. 2024 Jan 29;25(3):1639. doi: 10.3390/ijms25031639.
Due to prolonged forced positioning, the incidence of intraoperative pressure injuries is high. This study aimed to explore the impact of small-molecule antiplatelet drugs on pressure injuries by locally applying them before an injury occurs. In the first part of this study, water-soluble tracers with different molecular weights were applied to normal and early-stage pressure-injured skin. Through digital cameras, spectrophotometers, and histological observations, the penetration of tracers into the epidermis was clarified. In the second part of this study, a water-soluble antiplatelet drug called Trapidil (molecular weight = 205 Da) was applied to the left side of the back of a rat before, during, and after compression, and the contralateral side served as a non-intervention control group. The differences in pressure injuries between the two groups were observed through a digital camera, an ultraviolet camera, and temperature measurement, and skin circulation and perfusion were assessed via an intravenous injection of Evans Blue. The first part of this study found that water-soluble tracers did not easily penetrate normal skin but could more easily penetrate pressure-damaged skin. The smaller the molecular weight of the tracer, the easier it penetrated the skin. Therefore, in the next step of research, water-soluble drugs with smaller molecular weights should be selected. The second part of this study found that, compared with the control group, the occurrence rates and areas of ulcers were lower, the gray value was higher, and the skin temperature was lower in the Trapidil group ( < 0.05). After the intravenous Evans Blue injection, skin circulation and perfusion in the Trapidil group were found to be better. In conclusion, this study found that the topical skin application of a small-molecule antiplatelet agent may have significant effects against pressure injuries by improving post-decompression ischemia, providing new insights into the prevention and treatment of intraoperative pressure injuries.
由于长时间被迫保持特定体位,术中压疮的发生率较高。本研究旨在通过在损伤发生前局部应用小分子抗血小板药物来探讨其对压疮的影响。在本研究的第一部分,将具有不同分子量的水溶性示踪剂应用于正常和早期压疮皮肤。通过数字相机、分光光度计和组织学观察,阐明了示踪剂进入表皮的渗透情况。在本研究的第二部分,在大鼠背部左侧在受压前、受压时和受压后应用一种水溶性抗血小板药物 Trapidil(分子量=205Da),并将右侧作为非干预对照组。通过数字相机、紫外线相机和温度测量观察两组压疮的差异,通过静脉注射 Evans 蓝评估皮肤循环和灌注。本研究第一部分发现水溶性示踪剂不易穿透正常皮肤,但更容易穿透受压损伤的皮肤。示踪剂的分子量越小,越容易穿透皮肤。因此,在下一步研究中,应选择分子量更小的水溶性药物。本研究第二部分发现,与对照组相比,Trapidil 组溃疡的发生率和面积较低,灰度值较高,皮肤温度较低(<0.05)。静脉注射 Evans 蓝后,发现 Trapidil 组皮肤循环和灌注更好。总之,本研究发现,小分子抗血小板药物局部皮肤应用可能通过改善减压后缺血对压疮有显著作用,为术中压疮的预防和治疗提供了新的思路。