Rodrigues Adrian E, Dolivo David M, Hou Chun, Li Yingxing, Sun Lauren S, Mustoe Thomas A, Hong Seok Jong, Galiano Robert D
Department of Surgery, Division of Plastic Surgery Northwestern University Feinberg School of Medicine, Chicago, USA.
Department of Plastic and Cosmetic Surgery First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Adv Med. 2024 Sep 21;2024:2281747. doi: 10.1155/2024/2281747. eCollection 2024.
Skin wounds, whether medically or incidentally induced, are always at a risk of becoming infected, but the infection risks are greater when the wounds are recovering under ischemic, poorly perfused conditions. which frequently infects cutaneous and soft tissue, can infect to a greater extent when wounds are poorly perfused. Bad as this may be, both MSSA and MRSA strains of can cause severe infections, with MRSA being considered more aggressive.
In this study, we used a lagomorph ear excisional wound model to initially test the influence of partial ischemia on uninfected wound healing. We then subsequently test the same ischemic injury model under an active MSSA infection and compared these wounds against normally perfused MSSA-infected wounds. Lastly, we test whether differences in healing exist between MSSA-infected and MRSA-infected wounds, both under the same ischemic model.
The data suggest that partial ischemia considerably reduces healing of noninfected wounds (epithelial gap =, granulation gap =, and granulation area =). Similarly, partial ischemic wounds coupled with MSSA infection display healing impairments against likewise-infected wounds healing under normal perfusion (epithelial gap =, granulation gap =, and granulation area =). No significant differences were observed between MSSA-infected and MRSA-infected wounds healing under ischemia.
The data produced quantitative differences in healing under various conditions consequent to ischemia and infection. Although it is well recognized that ischemia and infection adversely influence healing, by testing these conditions, we determined the detrimental magnitude such circumstances inflict on skin healing, thereby providing a relative reference to compare and gauge when met with similar conditions clinically.
皮肤伤口,无论是医源性还是意外造成的,都始终存在感染风险,但当伤口在缺血、灌注不良的条件下愈合时,感染风险更高。经常感染皮肤和软组织的[具体病菌名称未给出],在伤口灌注不良时感染程度会更高。尽管情况可能很糟糕,但[具体病菌名称未给出]的甲氧西林敏感金黄色葡萄球菌(MSSA)和耐甲氧西林金黄色葡萄球菌(MRSA)菌株都可引起严重感染,其中MRSA被认为更具侵袭性。
在本研究中,我们首先使用兔耳切除伤口模型来测试局部缺血对未感染伤口愈合的影响。随后,我们在活跃的MSSA感染情况下测试相同的缺血损伤模型,并将这些伤口与正常灌注的MSSA感染伤口进行比较。最后,我们测试在相同的缺血模型下,MSSA感染伤口和MRSA感染伤口之间是否存在愈合差异。
数据表明,局部缺血会显著降低未感染伤口的愈合速度(上皮间隙 =[具体数值未给出],肉芽间隙 =[具体数值未给出],肉芽面积 =[具体数值未给出])。同样,局部缺血伤口合并MSSA感染与正常灌注下同样感染的伤口相比,愈合受损(上皮间隙 =[具体数值未给出],肉芽间隙 =[具体数值未给出],肉芽面积 =[具体数值未给出])。在缺血条件下愈合的MSSA感染伤口和MRSA感染伤口之间未观察到显著差异。
数据显示在缺血和[感染]的各种情况下,愈合存在定量差异。尽管缺血和感染对愈合有不利影响已得到充分认识,但通过测试这些条件,我们确定了这些情况对皮肤愈合造成的有害程度,从而为临床遇到类似情况时进行比较和评估提供了相对参考。