Nathan P, MacMillan B G, Holder I A
Infect Immun. 1975 Aug;12(2):257-60. doi: 10.1128/iai.12.2.257-260.1975.
We describe the in situ production of a burn wound dressing applied to eschar that completely isolates burned tissue from contamination with Pseudomonas aeruginosa. Anesthetized, adult rats were subjected to a scald burn over 10% of their body surfaces. One-half hour later a test dressing presumed to be a barrier to bacterial contamination of the wound was applied to the burned surface. Tannic acid, vaseline, ethyl linoleate, collodion, and polyhydroxethylmethacrylate (PHEMA) were evaluated. Each agent was applied directly to the burned surface. A solid film of the PHEMA was produced on the eschar by addition of solvent and a powdered form of the polymer. The surface of each synthetic dressing was contaminated 30 min after application by the addition of 10(8) P. aeruginosa. Also, a control set of rats was burned and their eschars were directly contaminated without application of the test dressing. Seven days later the contaminated muscle under the burned area in 10 control rats had P. aeruginosa counts of 10(7) to 10(8) per g of muscle (wet weight). Of the materials tested, only PHEMA consistently acted as an effective barrier dressing, reducing bacteria in the muscle to undetectable levels in 11 of 14 tests. It was also possible to treat contaminated eschar through this synthetic dressing by topical application of antibiotics to the barrier surface. The results suggest a novel clinical approach in which a barrier dressing could be used to isolate a burn eschar from environmental and subject contamination until the wound site is ready for grafting.
我们描述了一种应用于焦痂的烧伤创面敷料的原位生产方法,该敷料能使烧伤组织完全与铜绿假单胞菌污染隔离开来。对成年麻醉大鼠体表10%的面积进行烫伤。半小时后,将一种被认为可防止伤口细菌污染的测试敷料应用于烧伤表面。对单宁酸、凡士林、亚油酸乙酯、火棉胶和聚羟乙基甲基丙烯酸酯(PHEMA)进行了评估。每种试剂都直接应用于烧伤表面。通过添加溶剂和聚合物粉末形式在焦痂上形成PHEMA固体膜。在应用测试敷料30分钟后,通过添加10⁸ 铜绿假单胞菌来污染每个合成敷料的表面。此外,设置一组对照大鼠进行烧伤,其焦痂直接被污染,不应用测试敷料。七天后,10只对照大鼠烧伤区域下方受污染的肌肉中,每克肌肉(湿重)的铜绿假单胞菌数量为10⁷至10⁸ 。在测试的材料中,只有PHEMA始终作为一种有效的屏障敷料,在14次测试中的11次将肌肉中的细菌数量减少到检测不到的水平。通过在屏障表面局部应用抗生素,也可以通过这种合成敷料治疗受污染的焦痂。结果提示了一种新的临床方法,即可以使用屏障敷料将烧伤焦痂与环境和患者污染隔离开来,直到伤口部位准备好进行移植。