ε-聚赖氨酸—聚丙烯酸酯敷料的制备及其对创面的抗菌自洁功能的实验研究

发布时间：2019-03-27 14:38

【摘要】：目的:随着社会的发展,高能量外伤引起的开放性创面日益增多,对于开放性创面的处理除了及时的彻底清创外术后良好的创面护理至关重要,目前临床对于创面护理使用的敷料基本都是利弊参半,尚无同时具有抗菌及自动清洁的敷料应用于临床,本实验设计一款抗菌自洁敷料,并通过动物实验验证其有效性。方法:首先对聚丙烯酸酯的吸液性能和保液性能进行检测。然后取10只新西兰白兔,于全麻后于背部剃毛后沿脊柱两侧分别行伤口造模,均为直径为2.0cm的4个圆形创面。并予以每个创面6×108/ml的金葡菌0.4ml均匀涂抹,然后随机使用ε-聚赖氨酸-聚丙烯酸酯敷料(以下用ε-PL-SAP表示)、ε-聚赖氨酸纱布(以下用ε-PL纱布表示)、普通医用纱布覆盖四个创面。3天后予以隔日换药(伤口观察日除外)并观察伤口情况,分别于术后7天、14天、21天观察所有伤口创面面积、创面愈合积分PUSH积分并记录,并于术后第三周取创面组织进行石蜡包埋、切片,行组织学观察,并于术后第三天换药前拆除敷料,无菌棉签取各创面分泌物、做细菌培养,比较各创面菌落数。最终的实验数据采用spss22.0进行统计学处理,结果中的数据采用sx?表示,采用方差分析统计4组试验数据并相互对比有无差异,P0.05为差异具有统计学意义。结果:聚丙烯酸酯敷料在三种溶液中浸泡时在前2分钟吸收是最迅速的,达到最大量的75%,2min过后材料吸收趋于缓慢,并于7min达到吸收最大值,基本趋于饱和,且饱和后的吸液量达到自身体重的20-30倍,并且,等量的聚丙烯酸酯材料对生理盐水、纯水、以及新鲜兔血的吸收效果无明显差异。在创面造模成功并使用敷料后7、14、21天观察所有兔子的四个创面面积、创面愈合积分,得出ε-PL-SAP敷料伤口的这两项项指标均值均优于单纯使用SAP敷料伤口及单纯使用ε-PL纱布的伤口以及单纯使用纱布组,且P0.05.术后第三天无菌棉签取各创面分泌物做细菌培养,观察菌落数,取均值比较,结果提示ε-PL-SAP组伤口金葡菌菌落数与其余三组比较有明显统计学差异,且菌落数明显低于其余三组,在造模成功后第21日取创面做切片HE染色,并行显微镜观察,结果提示:,使用ε-PL-SAP敷料伤口较其余三组比较有明显的肉芽组织生成,新生毛细血管及大量的成纤维细胞丰富,炎性细胞减少。结论:1.ε-聚赖氨酸-聚丙烯酸酯敷料对不同的液体均有良好的吸液性能。2.ε-聚赖氨酸-聚丙烯酸酯敷料具有良好的保液性能,能有效为创面提供微湿润。3.ε-聚赖氨酸-聚丙烯酸酯敷料在动物创面实验中具有良好的促进创面愈合、肉芽生长及抗菌功效。
[Abstract]:Objective: with the development of society, the open wound caused by high energy trauma is increasing day by day. It is very important for the treatment of open wound, besides timely and thorough debridement, to provide good wound care after operation. At present, the clinical dressing for wound care is mixed in both advantages and disadvantages, and there is no anti-bacterial dressing and auto-cleaning dressing in clinical application. In this experiment, an antibacterial self-cleaning dressing was designed, and its effectiveness was verified by animal experiments. Methods: firstly, the absorbency and retention of polyacrylate were tested. Then 10 New Zealand white rabbits were taken and shaved on the back after general anesthesia. The wound models were made along both sides of the spine after general anesthesia, all of which were 4 round wounds with the diameter of 2.0cm. Each wound was evenly smeared with 6 脳 108/ml staphylococcus aureus 0.4ml and then randomly used 蔚-poly-lysine-polyacrylate dressing (蔚-PL-SAP) and 蔚-poly-lysine gauze (蔚-PL gauze). Four wounds were covered with gauze. After 3 days, dressing was changed every other day (except the day of wound observation) and the wound condition was observed. All wounds were observed at 7 days, 14 days and 21 days after operation, and the PUSH integral of wound healing was recorded. At the third week after operation, the wound tissue was paraffin embedded, sliced, and histologically observed. The dressing was removed before dressing change on the third day after operation, and the exudates of each wound were taken out with sterile cotton for bacterial culture, and the number of colonies in each wound was compared. The final experimental data were statistically processed by spss22.0, and the data in the results were sx?. It was indicated that there was no difference between the 4 groups of test data by ANOVA, and the difference was statistically significant (P0.05). Results: the absorption of polyacrylate dressings in the first 2 minutes after immersion in three kinds of solutions was the fastest, reaching the maximum of 75%. After 2 minutes, the absorption of polyacrylate dressings tended to slow down, and reached the maximum absorption value at 7min, which tended to saturation. The absorbed amount of saturated polyacrylate was 20 times of its own body weight, and there was no significant difference in the absorption of normal saline, pure water and fresh rabbit blood with the same amount of polyacrylate. At 7, 14, 21 days after successful modeling of the wound and application of dressing, the four wound areas and wound healing scores of all rabbits were observed. The results showed that the average values of the two indexes of 蔚-PL-SAP dressing wound were better than those of SAP dressing wound, 蔚-PL gauze group and pure gauze group, and P0.05 was better than that of 蔚-PL dressing wound. On the third day after operation, aseptic cotton was used for bacterial culture to observe the number of bacterial colonies. The results showed that there was significant difference between 蔚-PL-SAP group and the other three groups in the number of Staphylococcus aureus colonies in wound, and the results showed that there was a significant difference between 蔚-Staphylococci group and other three groups. The colony number was significantly lower than that of the other three groups. The wound was stained with HE and observed by microscope on the 21st day after successful establishment of the model. The results showed that there was obvious granulation tissue formation in the wound with 蔚-PL-SAP dressing compared with the other three groups. New capillaries and a large number of fibroblasts are abundant and inflammatory cells decrease. 蔚-poly-lysine-polyacrylate dressings have good liquid absorption properties for different liquids. 2. 蔚-poly-lysine-polyacrylate dressings have good liquid retention properties. 3. 蔚-polylysine-polyacrylate dressing can promote wound healing, granulation growth and antibacterial effect in animal wound experiments.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R641

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