摘要
目的研究人慢性创面经封闭负压引流(vacuum-assistedclosure,VAC)治疗前后,创面渗出液中胶原酶活性的变化,以部分阐明VAC促进慢性创面愈合的机理。方法取4例急性创面在术后1、2、3d的创面引流液(乳癌术后),同时收集6例慢性创面(4例静脉性溃疡,2例压力性溃疡)在VAC治疗前以及治疗后2、4、6d的创面渗出液,利用酶谱分析的方法,观察各时间点的渗出液对可溶性III型胶原的降解情况,同时应用强力霉素抑制实验来分析渗出液中胶原酶的类型。结果急性创面引流液可以部分降解III型胶原,随时间推移变化较小,慢性创面渗出液中的胶原酶活性较高,VAC治疗前基本将III型胶原全部降解,随时间推移、降解减少,胶原酶活性下降,强力霉素抑制实验证明在100μmol/L浓度时无抑制,在600μmol/L浓度时出现部分抑制。结论在慢性创面渗出液中胶原酶活性增高,VAC的应用可以降低胶原酶的活性,阻止胶原蛋白大量降解,利于创面愈合,在慢性创面渗出液中胶原酶应主要是MMP-1型(成纤维细胞型)。
Objective To study the variations of collagenase activity in exudates of human chronic wound before and after treatment of VAC so as to partly disclose the mechanisms of VAC in promoting chronic wound healing. Methods The exudates of acute wounds （postoperative breast cancer） were postoperatively collected at day 1,2,3 ,and in 6 chronic wounds （4 cases of venous ulcer, 2 cases of pressure sore） the exudates were also collected before and 2,4,6 days after the treatment with VAC. The type-Ⅲ collagen degradation from the exudates was checked with zymography timepoint. The types of the collagenase in exudates were evaluated by using doxycycline inhibition. Results Drainage fluids from acute wound might degrade type-Ⅲ collagen partly with no changes at day 1,2,3 .There were high collagenase activities in chronic wound exudates. Exudates from patients before treatment with VAC can degrade type-Ⅲ collagen completely. But collagenase activities became less and less after VAC. Doxycyline inhibition tests indicated that it can＇ t inhibit the activity of eollagenase at 100 μmol/L concentration, until it reached 600 μmol/L. Conclusions Collagenase activity is elevated in chronic wounds. VAC may be lower the collagenase activity, prevent collagen from degrading abundantly and promote wound healing. Collagenase is mainly MMP-1 type（fibroblast-type） in chronic wound exudates.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2006年第6期465-467,共3页
Chinese Journal of Plastic Surgery
关键词
封闭负压引流
慢性创面
胶原酶
Vacuum-assisted closure（VAC）
Chronic wound
Collagenase
