Tur E, Bolton L, Constantine B E
Department of Dermatology, Sourasky Medical Center, Tel Aviv University, Israel.
J Am Acad Dermatol. 1995 Aug;33(2 Pt 1):217-21. doi: 10.1016/0190-9622(95)90238-4.
Oxygen deficit is a key factor associated with delayed healing of ischemic wounds in human beings. Topical oxygen-releasing compounds such as hydrogen peroxide or tetrachlorodecaoxide have been suggested as therapy for ischemic tissue.
Our purpose was to monitor the effect of hydrogen peroxide cream on the process of ischemic ulcer healing with a model for ischemic ulcers in the guinea pig.
Measurement of vascular perfusion with a laser Doppler velocimeter and gross observations of percentage of nonnecrotic wound surface were made on ischemic wounds in guinea pigs after treatment with either a hydrogen peroxide cream or a placebo cream.
Visual evaluations of the percentage of nonnecrotic wound surface showed no statistically significant differences among the treatments. In contrast, vascular perfusion measurements resulted in statistically significant differences. Blood flow was significantly higher up to day 15 in ulcers treated with 2% hydrogen peroxide cream than in those treated with placebo cream. Vascular perfusion was significantly higher in ulcers treated with 3.5% hydrogen peroxide cream than in ulcers treated with either 1.5% hydrogen peroxide cream or placebo. Adjacent control sites in guinea pigs whose ulcers were treated with hydrogen peroxide cream showed increased vascular perfusion compared with corresponding sites in animals whose ulcers were treated with placebo. Even distant flank control sites of ulcers treated with 3.5% hydrogen peroxide cream showed increased vascular perfusion.
Treatment of ischemia-induced ulcers with hydrogen peroxide cream enhanced cutaneous blood recruitment not only to ulcers and adjacent sites, but also to distant sites.
缺氧是与人类缺血性伤口愈合延迟相关的关键因素。诸如过氧化氢或四氯十氧化物等局部释氧化合物已被提议用于治疗缺血组织。
我们的目的是用豚鼠缺血性溃疡模型监测过氧化氢乳膏对缺血性溃疡愈合过程的影响。
在用过氧化氢乳膏或安慰剂乳膏治疗后,用激光多普勒血流仪测量豚鼠缺血性伤口的血管灌注,并对非坏死创面百分比进行大体观察。
对非坏死创面百分比的视觉评估显示,各治疗组之间无统计学显著差异。相比之下,血管灌注测量结果存在统计学显著差异。在第15天之前,用2%过氧化氢乳膏治疗的溃疡中的血流明显高于用安慰剂乳膏治疗的溃疡。用3.5%过氧化氢乳膏治疗的溃疡中的血管灌注明显高于用1.5%过氧化氢乳膏或安慰剂治疗的溃疡。用过氧化氢乳膏治疗溃疡的豚鼠的相邻对照部位与用安慰剂治疗溃疡的动物的相应部位相比,血管灌注增加。甚至用3.5%过氧化氢乳膏治疗溃疡的远处胁腹对照部位也显示血管灌注增加。
用过氧化氢乳膏治疗缺血性溃疡不仅可增强溃疡及其相邻部位的皮肤血液供应,还可增强远处部位的皮肤血液供应。