高吸型壳聚糖敷料的创面止血及促愈合效果

摘要

背景：通过化学改性可提升壳聚糖敷料自身的高吸液性、高容量吸液性、高抗菌性等方面的性能。　　目的：观察高吸型壳聚糖敷料的创面止血及促愈合效果。　　方法：①小静脉止血实验：制作家兔皮肤对称性渗血伤口，两侧伤口分别敷以高吸型壳聚糖敷料和灭菌纱布，记录止血时间和出血量；②Ⅱ度烫伤创面修复实验：取清洁级SD大鼠40只，制作背部深Ⅱ度烫伤创面，随机分为2组，实验组创面局部以高吸型壳聚糖敷料包扎，对照组以凡士林纱布包扎，修复后3，7，14，21 d，观察愈合情况，取创面组织进行病理组织学分析。　　结果与结论：①小静脉止血实验：高吸型壳聚糖敷料组出血量与止血时间均低于灭菌纱布组(P<0.05， P<0.01)；②Ⅱ度烫伤创面修复实验：实验组修复后7，14，21 d的未愈合创面面积均低于对照组(P<0.05)。修复后3 d，两组均可见创面皮肤表皮的鳞状上皮层坏死、真皮层内毛囊及皮肤附属器结构破坏，同时可见损伤皮肤组织内有不等数量的中性粒细胞和淋巴细胞浸润。修复后21 d，对照组上皮修复较好，有少许淋巴细胞浸润，可见痂皮；实验组上皮修复良好，可见完整新生鳞状上皮层，无炎症细胞浸润；③结果表明：高吸型壳聚糖敷料具有良好的创面止血和促创面愈合效果。%BACKGROUND:High liquid-absorbing property, high-capacity imbibition property and high antibacterial property of chitosan dressings can be promoted by chemical modification. OBJECTIVE:To observe the effect of high-absorbing chitosan dressings on hemostasis and wound healing. METHODS: (1) Venule bleeding experiment: symmetry oozing wounds were produced on the rabbit skin, which were respectively covered by high-absorbing chitosan dressings and sterile gauze. Then, hemostatic time and bleeding volume were recorded. (2) Deep II degree burn wound healing experiment: 40 Sprague-Dawley rats were selected to prepare deep II degree burn wounds on the back, and then model rats were randomly divided into two groups: experimental group with high-absorbing chitosan dressings and control group with vaseline gauze. After 3, 7, 14, 21 days, wound tissues were taken and analyzed histopathologicaly. RESULTS AND CONCLUSION: (1) Venule bleeding experiment: The bleeding amount and hemostatic time were significantly lower in the high-absorbing chitosan dressing group than the sterile gauze group (P < 0.05,P < 0.01). (2) Deep II degree burn wound healing experiment: the unhealed wound areas were significantly lower in the experimental group than the control group at days 7, 14, 21 after repair (P < 0.05). After 3 days of wound repair, necrosis of the squamous epithelial layer and the structural damage of the hair folicle in the corium layer and skin appendages were found in both two groups. Meanwhile, the infiltration caused by varying numbers of neutrophils and lymphocytes inside the damaged skin tissues was visible. After 21 days of repair, the epithelium healed wel in the control group, with a little lymphocyte infiltration and formation of crust on the skin surface; while in the experimental group, the epithelium healed wel, with complete squamous epithelial layer and no inflammatory cel infiltration. Thus, these experimental findings reveal that the high-absorbing chitosan dressing has an excelent effect on hemostasis and wound healing.