Borden E B, Sammartano R J, Dembe C, Boley S J
Surgery. 1985 Mar;97(3):331-6.
Metronidazole is gaining increasing acceptance as a perioperative antimicrobial agent. We studied the effect of metronidazole on wound healing in Sprague-Dawley rats, which received seven daily intraperitoneal injections of either metronidazole, 20 mg/kg/day, (simulating a therapeutic course) or equivalent volumes of physiologic saline solution. On the second day of treatment 25 treated rats and 20 control rats had full-thickness circular skin defects created on the back and standardized midline celiotomy incisions. The fascial incisions were closed with staples, and the abdominal skin was closed with silk sutures. On the seventh postoperative day all rats were put to death. The breaking strength of 1 cm wide segments of skin and fascial celiotomy wounds was measured, and the contraction of the open back wounds was computed. There was no significant difference in wound contraction or skin wound breaking strength, but fascial wound breaking strength was lower in treated rats than in control rats (283 versus 548 gm mean; 2 p less than 0.001). To determine whether metronidazole permanently altered or only temporarily delayed fascial wound healing, 39 additional rats treated with metronidazole and 40 control rats underwent celiotomies as described above on the second day of a 7-day course of treatment. Fascial wound breaking strength was measured 2, 3, and 5 weeks after operation. The wound breaking strength in rats treated with metronidazole remained significantly lower than that of control rats at 2 and 3 weeks (860 versus 1005 gm at 2 weeks and 1071 versus 1369 gm at 3 weeks; both 2 p less than 0.05), but at 5 weeks there was no significant difference between treated and control groups (1358 versus 1399 gm). Metronidazole apparently interferes with early fascial wound healing, but the wounds of treated rats ultimately attain the same strength as untreated controls.
甲硝唑作为一种围手术期抗菌药物越来越被广泛接受。我们研究了甲硝唑对斯普拉格-道利大鼠伤口愈合的影响，这些大鼠每天接受7次腹腔注射，剂量为20毫克/千克/天的甲硝唑（模拟一个治疗疗程）或等量的生理盐水溶液。在治疗的第二天，25只接受治疗的大鼠和20只对照大鼠在背部制造了全层圆形皮肤缺损，并进行了标准化的中线剖腹手术切口。筋膜切口用吻合钉缝合，腹部皮肤用丝线缝合。术后第七天所有大鼠被处死。测量1厘米宽的皮肤和筋膜剖腹手术伤口段的抗张强度，并计算背部开放性伤口的收缩情况。伤口收缩或皮肤伤口抗张强度没有显著差异，但治疗组大鼠的筋膜伤口抗张强度低于对照组（平均分别为283克和548克；P<0.001）。为了确定甲硝唑是永久性改变还是仅暂时延迟筋膜伤口愈合，在7天治疗疗程的第二天，另外39只接受甲硝唑治疗的大鼠和40只对照大鼠进行了上述剖腹手术。在术后2周、3周和5周测量筋膜伤口抗张强度。接受甲硝唑治疗的大鼠在2周和3周时伤口抗张强度仍显著低于对照组（2周时分别为860克和1005克，3周时分别为1071克和1369克；P均<0.05），但在5周时治疗组和对照组之间没有显著差异（分别为1358克和1399克）。甲硝唑显然会干扰早期筋膜伤口愈合，但治疗组大鼠的伤口最终达到与未治疗对照组相同的强度。
