針對糖尿病創(chuàng)口的抑菌敷料制備及促愈合性能評價
發(fā)布時間：2018-08-11 20:48
【摘要】：促進難愈合傷口的愈合至今仍是臨床上普遍存在的難題,而糖尿病病人創(chuàng)口更是經(jīng)久難愈,將直接影響病人的身體健康和生活質量。目前,臨床上對于難愈合創(chuàng)口的治療,主要采用藥物聯(lián)合敷料來進行,常用的敷料主要有傳統(tǒng)敷料、新型濕性敷料。傳統(tǒng)敷料幾乎沒有促愈合功效。新型濕性敷料能防止異物及空氣中的細菌侵入傷口,能夠有效減少感染的幾率,但其在濕潤環(huán)境下吸收滲液的特性及透水氣性差,最終感染情況出現(xiàn)較多。制備一種抑菌能力強、促愈合效果好、并能維持創(chuàng)面水分平衡的新型敷料具有深遠的學術意義和臨床應用價值。由于敷料要與患者創(chuàng)面處的組織直接接觸,應具有優(yōu)異的血液相容性、抑菌性及優(yōu)良的物理性能。絲素蛋白是一種來源廣泛的天然蛋白質,具有優(yōu)越的生物相容性,同時具有一定的抑菌性能,分解后產(chǎn)生的氨基酸能為創(chuàng)面提供營養(yǎng)物質。殼聚糖是一種天然多糖,具有優(yōu)異的止血止痛性、抑菌性和機體組織相容性,與絲素蛋白按照一定的比例混合后抑菌性隨之增強。生物活性玻璃是由無機成分制備得到,其中所含的鈣、磷離子能在體液中沉積,并形成羥基磷灰石層,非常有利于細胞的生長,能促進組織吸收營養(yǎng)物質及氧氣的進入。聚乙烯醇水凝膠含水量很高,易于改性、接枝,同時具有良好的生物相容性,現(xiàn)已廣泛用于生物材料及醫(yī)藥行業(yè)。因此,本課題將絲素蛋白、殼聚糖、生物活性玻璃及聚乙烯醇進行共混改性,以突出各材料的優(yōu)點,制備一種抑菌促愈合傷口敷料。本課題采用攪拌共混的方式依次加入絲素蛋白溶液、殼聚糖溶液,二者混合均勻后加入生物活性玻璃粉末,將三者混合均勻后加入聚乙烯醇溶液,得到絲素蛋白/殼聚糖/生物活性玻璃/聚乙烯醇混合液,經(jīng)反復冷凍-解凍后即得到抑菌促愈合敷料,并對該敷料的物理性能、抑菌性能、促傷口愈合性能、生物學性能進行了評價。敷料的物理學性能結果表明,敷料具有促進細胞生長的孔隙率,具有維持創(chuàng)面水分平衡的吸水率和保水率,通過調整各材料的比例可以改變其物理性能,在PVA/CS為4/6時敷料的物理性能最佳,透水氣性能最接近醫(yī)用敷料的理想值;從敷料浸提液的抑菌性結果可知,敷料對革蘭氏菌及綠膿桿菌均具有較強的抑制作用,并且隨著浸提濃度的增加其對細菌的抑制作用增強;敷料的促愈合性能結果表明,抑菌促愈合敷料能有效促進糖尿病大鼠創(chuàng)面的愈合,在同一時相點實驗組的創(chuàng)面愈合率均高于海藻酸鈉敷料、生物活性玻璃及空白對照;細胞毒性(MTT法)結果表明,抑菌促愈合敷料對細胞沒有細胞毒性,各實驗組評分均為0級,細胞相對增殖率(RGR)均大于100%,能促進細胞生長;血液相容性結果表明,各實驗組溶血度均小于5%,且當PVA/CS為4/6時,敷料的溶血度最低;各實驗組材料在50min時BCI值均高于70%;各不同比例敷料的血小板粘附率均低于40%,符合直接接觸血液用材料的安全性要求;皮膚刺激實驗結果表明,不同比例抑菌促愈合傷口敷料的浸提液及陰性對照對組皮膚均無刺激性,沒有紅斑、水腫,皮膚顯示正常,而陽性對照組卻出現(xiàn)了異常情況,有明顯的水腫、紅斑,抑菌促愈合敷料對皮膚沒有刺激性,實驗記為0分;急性全身毒性結果表明,實驗組與對照組動物均未出現(xiàn)異常,臟器均未出現(xiàn)紅腫、充血等病理現(xiàn)象,實驗組與對照組的體重增長率、食物利用率、體重相對增長數(shù)這三組實驗數(shù)據(jù)均不存在顯著性差異。研究表明,該抑菌促愈合敷料具有優(yōu)異的物理性能、抑菌性能、促愈合性能及生物學性能,有望作為治療難愈合創(chuàng)口的敷料使用。
[Abstract]:Promoting the healing of hard-to-heal wounds is still a common clinical problem, and diabetic wounds are more difficult to heal for a long time, which will directly affect the health and quality of life of patients. Wet dressings. Traditional dressings have little healing effect. New wet dressings can prevent foreign bodies and bacteria in the air from invading the wound, and can effectively reduce the risk of infection. However, in a humid environment, the characteristics of absorption of exudate and permeability of water are poor, resulting in more infections. Preparation of a strong bacteriostatic, good healing effect, and The new dressing, which can maintain the water balance of wound surface, has far-reaching academic significance and clinical application value. Because the dressing should have excellent blood compatibility, bacteriostasis and excellent physical properties if it is to be directly contacted with the tissue of wound surface, silk fibroin is a natural protein with a wide range of sources and excellent biocompatibility. Chitosan is a kind of natural polysaccharide with excellent hemostatic and analgesic properties, bacteriostatic properties and tissue compatibility. The antibacterial properties of chitosan mixed with silk fibroin in a certain proportion are enhanced. Bioactive glass is prepared from inorganic components. It is found that calcium and phosphorus ions can be deposited in body fluids and form hydroxyapatite layers, which are very conducive to cell growth and promote the absorption of nutrients and oxygen into tissues. Pharmaceutical industry. Therefore, silk fibroin, chitosan, bioactive glass and polyvinyl alcohol were blended and modified to produce a wound dressing which can inhibit bacteria and promote wound healing. Silk fibroin/chitosan/bioactive glass/polyvinyl alcohol mixture was obtained by mixing the three kinds of glass powder and adding PVA solution. After repeated freezing-thawing, the antibacterial and healing dressing was obtained. The physical properties, antibacterial properties, wound healing properties and biological properties of the dressing were evaluated. The results showed that the dressing had the porosity of promoting cell growth, the water absorption rate and the water retention rate of maintaining the water balance of wound surface, and the physical properties of the dressing could be changed by adjusting the proportion of each material. When PVA/CS was 4/6, the physical properties of the dressing were the best, and the permeability was the closest to the ideal value of the medical dressing. The results showed that the dressing had strong inhibitory effect on both Gram bacillus and Pseudomonas aeruginosa, and its inhibitory effect on bacteria increased with the increase of the concentration of extract. The results showed that the dressing could effectively promote wound healing in diabetic rats, and wound healing in the experimental group at the same time point. The results of cytotoxicity (MTT) showed that the dressing had no cytotoxicity to cells, and the scores of each experimental group were all 0, and the relative cell proliferation rate (RGR) was more than 100%, which could promote cell growth. The hemolysis degree of each experimental group was less than 5%. When PVA/CS was 4/6, the hemolysis of the dressing was the lowest; the BCI values of the experimental groups were higher than 70% at 50 min; the platelet adhesion rates of the dressings with different proportions were all lower than 40%, which met the safety requirements of direct contact with blood materials; the skin irritation test results showed that the extracts of the dressings with different proportions of bacteriostasis and wound healing and negative control. No irritation to the skin, no erythema, edema, skin showed normal, while the positive control group showed abnormal conditions, there was obvious edema, erythema, bacteriostasis and healing dressing on the skin no irritation, the experimental score was 0; acute systemic toxicity results showed that the experimental group and the control group animals did not appear abnormal, organs did not appear red. There was no significant difference between the experimental group and the control group in the growth rate of body weight, food utilization rate and the relative growth of body weight. Use of dressings.
【學位授予單位】：重慶理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R318.08
本文編號：2178199
[Abstract]:Promoting the healing of hard-to-heal wounds is still a common clinical problem, and diabetic wounds are more difficult to heal for a long time, which will directly affect the health and quality of life of patients. Wet dressings. Traditional dressings have little healing effect. New wet dressings can prevent foreign bodies and bacteria in the air from invading the wound, and can effectively reduce the risk of infection. However, in a humid environment, the characteristics of absorption of exudate and permeability of water are poor, resulting in more infections. Preparation of a strong bacteriostatic, good healing effect, and The new dressing, which can maintain the water balance of wound surface, has far-reaching academic significance and clinical application value. Because the dressing should have excellent blood compatibility, bacteriostasis and excellent physical properties if it is to be directly contacted with the tissue of wound surface, silk fibroin is a natural protein with a wide range of sources and excellent biocompatibility. Chitosan is a kind of natural polysaccharide with excellent hemostatic and analgesic properties, bacteriostatic properties and tissue compatibility. The antibacterial properties of chitosan mixed with silk fibroin in a certain proportion are enhanced. Bioactive glass is prepared from inorganic components. It is found that calcium and phosphorus ions can be deposited in body fluids and form hydroxyapatite layers, which are very conducive to cell growth and promote the absorption of nutrients and oxygen into tissues. Pharmaceutical industry. Therefore, silk fibroin, chitosan, bioactive glass and polyvinyl alcohol were blended and modified to produce a wound dressing which can inhibit bacteria and promote wound healing. Silk fibroin/chitosan/bioactive glass/polyvinyl alcohol mixture was obtained by mixing the three kinds of glass powder and adding PVA solution. After repeated freezing-thawing, the antibacterial and healing dressing was obtained. The physical properties, antibacterial properties, wound healing properties and biological properties of the dressing were evaluated. The results showed that the dressing had the porosity of promoting cell growth, the water absorption rate and the water retention rate of maintaining the water balance of wound surface, and the physical properties of the dressing could be changed by adjusting the proportion of each material. When PVA/CS was 4/6, the physical properties of the dressing were the best, and the permeability was the closest to the ideal value of the medical dressing. The results showed that the dressing had strong inhibitory effect on both Gram bacillus and Pseudomonas aeruginosa, and its inhibitory effect on bacteria increased with the increase of the concentration of extract. The results showed that the dressing could effectively promote wound healing in diabetic rats, and wound healing in the experimental group at the same time point. The results of cytotoxicity (MTT) showed that the dressing had no cytotoxicity to cells, and the scores of each experimental group were all 0, and the relative cell proliferation rate (RGR) was more than 100%, which could promote cell growth. The hemolysis degree of each experimental group was less than 5%. When PVA/CS was 4/6, the hemolysis of the dressing was the lowest; the BCI values of the experimental groups were higher than 70% at 50 min; the platelet adhesion rates of the dressings with different proportions were all lower than 40%, which met the safety requirements of direct contact with blood materials; the skin irritation test results showed that the extracts of the dressings with different proportions of bacteriostasis and wound healing and negative control. No irritation to the skin, no erythema, edema, skin showed normal, while the positive control group showed abnormal conditions, there was obvious edema, erythema, bacteriostasis and healing dressing on the skin no irritation, the experimental score was 0; acute systemic toxicity results showed that the experimental group and the control group animals did not appear abnormal, organs did not appear red. There was no significant difference between the experimental group and the control group in the growth rate of body weight, food utilization rate and the relative growth of body weight. Use of dressings.
【學位授予單位】：重慶理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R318.08
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，本文編號：2178199
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