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纤维蛋白封闭剂(TISSEEL)对烧伤治疗有效吗?一项大鼠组织病理学研究。

Could Fibrin Sealants (TISSEEL) Be Effective in the Management of Burn Injuries? A Histopathological Study in Rats.

作者信息

Nikolaou Christina, Frountzas Maximos, Schizas Dimitrios, Pergialiotis Vasilios, Kapetanakis Emmanouil I, Kontzoglou Konstantinos, Perrea Despina N, Koniaris Efthymios, Kykalos Stylianos, Iliopoulos Dimitrios

机构信息

Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Department of Plastic & Reconstructive Surgery, Burn Center, General Hospital of Athens "G. Genimatas", 11527 Athens, Greece.

出版信息

Med Sci (Basel). 2024 Dec 19;12(4):75. doi: 10.3390/medsci12040075.

Abstract

Burn injuries remain a major clinical problem worldwide, which require special management by experienced plastic surgeons. However, they cannot be available in every healthcare unit; consequently, there is a need for effective treatment options that could be utilized by a wide range of non-expert healthcare professionals. The aim of the present experimental study was to investigate the safety and efficacy of using a fibrin sealant (TISSEEL) compared to the conventional treatment with sulfadiazine on partial-thickness burn in a rat animal model. A cohort of Sprague Dawley rats underwent partial-thickness contact thermal burn wounds and were divided into three study groups: control group (no treatment), silver sulfadiazine cream group and TISSEEL group. Following animal sacrifice, a blinded histopathologic analysis was conducted regarding inflammatory response, healing and tissue regeneration. In total, 30 animals were included with a median weight of 236 ± 10 g. Two animals from the control group died on the first postoperative day. Animals in the TISSEEL group presented dominant collagen expression compared to animals in the control and silver sulfadiazine cream group ( = 0.000). Histopathologic analysis also demonstrated marked leukocyte infiltration ( = 0.009), increased neovascularization ( = 0.000) and higher fibroblast expression ( = 0.002) in the TISSEEL group compared to the other two groups. TISSEEL seems to be a safe alternative (or even principal) option for the initial therapeutic approach of partial-thickness burn injuries. Moreover, it seems to be superior to silver sulfadiazine in terms of tissue healing and regeneration. However, additional experimental as well as clinical research is necessary prior to implementation in clinical practice.

摘要

烧伤仍是全球范围内的一个重大临床问题,需要经验丰富的整形外科医生进行特殊处理。然而,并非每个医疗单位都能配备此类医生;因此,需要有可供广大非专业医疗人员使用的有效治疗方案。本实验研究的目的是在大鼠动物模型中,研究与使用磺胺嘧啶的传统治疗方法相比,使用纤维蛋白密封剂(TISSEEL)治疗浅度烧伤的安全性和有效性。一组斯普拉格-道利大鼠遭受浅度接触性热烧伤,被分为三个研究组:对照组(不治疗)、磺胺嘧啶银乳膏组和TISSEEL组。在动物处死后,对炎症反应、愈合和组织再生进行了盲法组织病理学分析。总共纳入30只动物,中位数体重为236±10克。对照组有两只动物在术后第一天死亡。与对照组和磺胺嘧啶银乳膏组的动物相比,TISSEEL组的动物呈现出占主导地位的胶原蛋白表达(P = 0.000)。组织病理学分析还显示,与其他两组相比,TISSEEL组有明显的白细胞浸润(P = 0.009)、新血管形成增加(P = 0.000)和成纤维细胞表达更高(P = 0.002)。TISSEEL似乎是浅度烧伤初始治疗方法的一种安全选择(甚至可能是主要选择)。此外,在组织愈合和再生方面,它似乎优于磺胺嘧啶银。然而,在临床实践中应用之前,还需要进行更多的实验以及临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9af5/11677266/3b6bbbefe0a8/medsci-12-00075-g001.jpg

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