Shamberger R C, Devereux D F, Brennan M F
Int Adv Surg Oncol. 1981;4:15-58.
A review of experimental studies of chemotherapeutic agents and wound healing has demonstrated impairment of healing by a wide variety of agents. The extent of impairment by several agents (corticosteroids, Adriamycin, methotrexate, and cyclophosphamide) is dependent upon the interval between administration and wounding. If given within three to four days of wounding significant impairment results, but beyond that interval, impairment is minimal. Studies in animals with some agents (adriamycin, nitrogen mustard, cyclophosphamide, and methotrexate) have shown a dose-dependent impairment of healing, but extrapolation of these doses to regimens employed in man is impossible. Information regarding complications of chemotherapeutic agents in wound healing in man is available from adjuvant studies. No increased frequency of complications from nitrogen mustard, thio-TEPA, or cyclophosphamide occurred, even when these agents were given in the immediate perioperative period. Increased wound complications occurred with 5-fluorouracil when a 60 mg/kg dose was begun seven days after surgery but not when it was begun 14 days after surgery. These results stress the need for continued attention to wound complication occurring in adjuvant studies, and suggest that delay of treatment until seven days after surgery should produce minimal impairment.
一项关于化疗药物与伤口愈合的实验研究综述表明，多种药物会损害伤口愈合。几种药物（皮质类固醇、阿霉素、甲氨蝶呤和环磷酰胺）造成损害的程度取决于给药与受伤之间的间隔时间。如果在受伤后三到四天内给药，会导致明显的损害，但超过这个间隔时间，损害就很小。对动物使用某些药物（阿霉素、氮芥、环磷酰胺和甲氨蝶呤）的研究表明，愈合存在剂量依赖性损害，但无法将这些剂量外推至人类使用的方案。关于化疗药物在人类伤口愈合中并发症的信息可从辅助研究中获得。即使在围手术期立即使用氮芥、噻替派或环磷酰胺，并发症的发生率也没有增加。当术后七天开始使用60mg/kg剂量的5-氟尿嘧啶时，伤口并发症会增加，但术后14天开始使用则不会。这些结果强调了在辅助研究中持续关注伤口并发症的必要性，并表明将治疗推迟到术后七天应能使损害最小化。
