Agren M S, Everland H
Department of Dermatology, University of Miami School of Medicine, Florida, USA.
Acta Derm Venereol. 1997 Mar;77(2):127-31. doi: 10.2340/0001555577127131.
Hydrocolloid occlusive dressings are beneficial in wound management in many respects, although the adhesive matrix may disintegrate when in contact with wounds. The purpose of this study was to determine: (1) if material from two hydrocolloid dressings-Comfeel and Duoderm-showing differences in adhesive cohesion, can be chemically identified in granulation tissue; and (2) if the presence of this material influences cutaneous wound healing. In full-thickness skin wounds in rats, components from the two hydrocolloid dressings were phagocytosed as indicated by the presence of foam cells. Extracellular vacuoles (100-400 microns in size) occupied about 25% of the granulation tissue volume in the Duoderm group but less than 5% in the Comfeel group, a statistically significant difference (p < 0.001). The vacuoles contained hydrophobic polymers derived from the respective hydrocolloid dressing, as analyzed by Fourier Transform Infrared (FT-IR) microscopy. Wound contraction did not differ significantly between the two hydrocolloid dressings. Wounds treated with Comfeel were significantly (p < 0.05) more epithelialized (mean: 78%) than those treated with Duoderm (mean: 41%). The proliferative activity in wound epithelium, as measured immunohistochemically by bromodeoxyuridine incorporation, was similar for the two treatment groups, indicating that epithelial migration was impaired in Duoderm-treated wounds. In summary, extensive incorporation of hydrophobic dressing material from hydrocolloid dressings may render the wound bed less suitable for epithelial migration during acute secondary wound healing.
水胶体封闭敷料在伤口处理的许多方面都有益处,尽管其粘性基质在与伤口接触时可能会分解。本研究的目的是确定:(1)两种水胶体敷料(康惠尔和多爱肤)的材料,其粘性凝聚力存在差异,是否能在肉芽组织中被化学鉴定出来;(2)这种材料的存在是否会影响皮肤伤口愈合。在大鼠的全层皮肤伤口中,如泡沫细胞的存在所示,两种水胶体敷料的成分被吞噬。细胞外液泡(大小为100 - 400微米)在多爱肤组中占肉芽组织体积的约25%,而在康惠尔组中小于5%,差异具有统计学意义(p < 0.001)。通过傅里叶变换红外(FT - IR)显微镜分析,这些液泡含有源自各自水胶体敷料的疏水聚合物。两种水胶体敷料之间的伤口收缩没有显著差异。用康惠尔处理的伤口上皮化程度显著更高(p < 0.05)(平均:78%),而用多爱肤处理的伤口上皮化程度较低(平均:41%)。通过溴脱氧尿苷掺入免疫组织化学测量,两个治疗组伤口上皮中的增殖活性相似,这表明多爱肤处理的伤口上皮迁移受损。总之,在急性二期伤口愈合过程中,水胶体敷料中的疏水敷料材料大量掺入可能使伤口床不太适合上皮迁移。