纳米载银磷酸锆抗菌聚氨酯的抗菌性能****

背景：聚氨酯材料具有优异的物理和化学性能,良好的生物相容性和抗凝血性能,且易加工成形,但聚氨酯制造的人工器官容易受到细菌等微生物的入侵。 目的：观察纳米载银无机抗菌剂对聚氨酯抗菌性能的影响。 方法：将纳米载银无机抗菌剂RHA-2,按0%(空白对照组),0.5%,1%,1.5%,2%,2.5%,5%比例添加到聚氨酯中。采用薄膜密着法检测抗菌聚氨酯对金黄色葡萄球菌、大肠杆菌的抑菌作用,并分析比较抗菌剂添加比例与聚氨酯抗菌性能的相关性。 结果与结论：添加纳米载银无机抗菌剂的聚氨酯对金黄色葡萄球菌、大肠杆菌具有良好的抑菌作用。抗菌剂添加比例0.5%~5%组对金黄色葡萄球菌的抑菌率分别为80.23%,91.32%,95.23%,99.19%,99.87%,99.93%,对大肠杆菌的抑菌率分别为76.70%,86.96%,92.92%,95.43%,99.34%,99.87%,显示抗菌性能随抗菌剂添加比例的上升而明显提高。表明纳米载银无机抗菌剂的添加赋予了聚氨酯优异的抗菌性能,且从抗菌角度出发,推荐纳米载银无机抗菌剂在聚氨酯中的添加比例不应低于1.5%。     

磺胺嘧啶银脂质水胶敷料治疗小面积皮肤缺损并伤口感染:生物相容性评价

背景:磺胺嘧啶银脂质水胶敷料是两种抗菌药物的结合体,可以发挥局部广谱、强效、持久的抗菌作用,能有效控制并预防伤口感染。目的:观察磺胺嘧啶银脂质水胶敷料治疗皮肤缺损性感染伤口的效果及生物相容性。方法:将30例皮肤缺损合并感染伤口患者采用随机分组方法分为观察组和对照组,两组均常规清创、换药后,观察组用生理盐水冲洗伤口后使用磺胺嘧啶银脂质水胶敷料覆盖,再以纱布包扎;对照组使用凡士林纱布覆盖后再以纱布包扎。观察两组治疗0,1,2周换药时的目测类比评分、敷料与伤口粘连情况、创面愈合率及痊愈时间。结果与结论:观察组治疗1,2周换药时的目测类比评分显著低于对照组(P0.01),治疗1,2周换药时的创面愈合率显著高于对照组(P0.05);观察组换药时敷料与伤口粘连情况明显少于对照组(P0.01),创面愈合时间明显短于对照组(P0.05)。表明磺胺嘧啶银脂质水胶敷料治疗皮肤缺损合并感染伤口效果好,可减轻换药时疼痛,有效控制感染,促进伤口愈合。     

载纳米银海藻酸钙敷料的制备及体外细胞毒性、抗菌性能的检测

以湿法纺丝法制得的海藻酸钙羧甲基纤维复合物作为敷料载体,再利用浸渍法将纳米银粒子搭载于敷料之上,制备质量分数为0.5、1、2、4%的载纳米银海藻酸钙抗菌敷料。采用紫外-可见光分光光度计和扫描电子显微镜检测敷料的物理学表征,并检测抗菌敷料的细胞毒性及抗菌性能。结果表明载纳米银海藻酸钙抗菌敷料表面可见纳米银均匀附着,于去离子水中可释放纳米银粒子,而载银量1%的海藻酸钙敷料无明显细胞毒性且对常见四种菌株均有良好的抗菌性能,是一个理想的载银浓度。     

纳米银敷料和磺胺嘧啶银霜治疗烧伤的对比研究

目的：对应用磺胺嘧啶银霜与纳米银敷料两种方式对患有烧伤疾病的患者实施治疗的临床效果进行对比研究。方法将我院收治的90例患有烧伤疾病的患者随机分为对照组和治疗组,平均每组45例。采用磺胺嘧啶银霜对对照组患者实施治疗;采用纳米银敷料对治疗组患者实施治疗。结果治疗组患者烧伤疾病治疗效果明显优于对照组;烧伤部位创面完全愈合时间和临床治疗方案实施总时间明显短于对照组;用药期间出现不良反应的人数明显少于对照组。结论应用纳米银敷料对患有烧伤疾病的患者实施治疗的临床效果非常明显。     

几种常用载银抗菌材料改性方式的研究现状

背景：银系抗菌剂具有生物安全性高,抗菌谱广,不产生耐药性等特点,是口腔无机抗菌剂中研究的热点。 目的：围绕几种常用银系无机抗菌剂载体结构、载银原理及对其载银方式、载银环境等改性增强其抗菌效果和改善原材料缺陷的研究现状作以综述。 方法：应用计算机检索CNKI数据库、OVID数据库2000/2010有关银系抗菌剂及其载体的相关文章。 结果与结论：无论是传统的沸石、磷酸盐等载体,还是新型的纳米载银方式,人们都从材料本身特征及其载银特质方面不断改性,以期得到用量更少,抑菌性能更优及克服了变色等性能缺陷的优质载银抗菌剂。以后载银无机抗菌材料的开发,除了可以更进一步地利用纳米载银以外,还可以往复合抑菌,缓释抑菌以及将抑菌作为其他材料的添加辅助性能等方面发展。     

纳米载银抗菌剂与四针状氧化锌抗白色念珠菌的性能

背景：口腔修复材料室温固化甲基丙烯酸甲酯的表面结构疏松多孔,极易附着各种细菌、微生物导致患者义齿性口炎的发生,所以在甲基丙烯酸甲酯中加入抗菌剂成为国内外学者研究的热点。 目的：比较加入纳米载银抗菌剂与四针状氧化锌抗菌剂后,室温固化甲基丙烯酸甲酯对白色念珠菌的抗菌活性。 方法：采用对倍稀释法测定纳米载银抗菌剂与四针状氧化锌抗菌剂对白色念珠菌的最小杀菌浓度。将纳米磷酸锆载银抗菌粉体与四针状氧化锌抗菌剂分别以0%,1%,2%,3%的质量比加入到室温固化甲基丙烯酸甲酯粉剂中,检测各组试件对白色念珠菌的抗菌率。 结果与结论：纳米载银抗菌剂对白色念珠菌的最小杀菌浓度为 40 g/L,四针状氧化锌抗菌剂对白色念珠菌的最小杀菌浓度为25 g/L。未加入纳米载银抗菌剂或四针状氧化锌抗菌剂的甲基丙烯酸甲酯几乎无抗菌活性,加入两种抗菌剂后其抗菌活性明显增加,随着加入抗菌剂质量比的增加,抗菌活性逐渐增强;当抗菌剂质量比增加到3%时,加入纳米载银抗菌剂的甲基丙烯酸甲酯抗菌率为92.23%,加入四针状氧化锌抗菌剂的甲基丙烯酸甲酯抗菌率为98.23%。表明纳米载银抗菌剂与四针状氧化锌抗菌剂对白色念珠菌均有抗菌效果,且四针状氧化锌抗菌剂比纳米载银系抗菌剂抗菌效果好。     

应用冷宁康敷料治疗烧伤和整形供皮区创面42例

目的通过使用新型烧伤敷料治疗二度烧伤和整形供皮区创面，旨在减少病人的痛苦，加快创面的愈合。方法在烧伤二度创面和整形供皮区创面应用冷宁康敷料42例，对照组分别用磺胺嘧啶银或油纱布，然后观察创面的愈合时间和质量。结果冷宁康组创面愈合时间缩短，愈合质量优于对照组。结果冷宁康敷料是一种安全可靠、使用方便的外用烧伤敷料。     

磺胺嘧啶银霜与金因肽联合治疗皮肤溃疡的疗效观察

目的进一步了解磺胺嘧啶银霜与金因肽联合外用换药治疗皮肤溃疡的临床疗效。方法对89例皮肤溃疡患者分别采用磺胺嘧啶银霜与金因肽联合治疗和呋喃西林溶液湿敷治疗，按照治疗方法分为磺胺嘧啶银霜与金因肽联合外用组（47例）和呋喃西林组（42例），将治疗效果分为痊愈、有效、无效三个层次，对比分析两组的治疗结果。结果磺胺嘧啶银霜与金因肽联合外用组痊愈率（80．85％）高于呋喃西林组，无效率（2．12％）低于呋喃西林组（P〈0．05）。结论磺胺嘧啶银霜与金因肽联合外用组在临床治疗皮肤溃疡的疗效明显优于呋喃西林组，磺胺嘧啶银霜与金因肽两者联合应用于皮肤溃疡，可有效预防和控制感染，促进肉芽组织生长，达到去腐生肌、抗炎消肿、防止粘连出血、加速上皮生长的作用，疗效显著。     

含纳米银壳聚糖/聚乙烯醇抗菌敷料的制备和性能

背景：抗菌敷料是预防创面发生侵袭性感染的重要措施之一,但长期使用抗生素会使细菌产生耐药性;同时,将抗菌材料与棉织物复合制得的抗菌敷料,生物相容性差,不宜用于创面的长期覆盖。 目的：制备一种具有良好的生物相容性、抗菌消炎性的新型抗菌生物敷料,并初步检测该材料的生物学性能。 方法：通过在乙醇/水/NaOH溶液中,构建一个纳米级的吸附相反应器,制得吸附纳米银的纳米SiO₂粉末;将载银的SiO₂粉末添加到壳聚糖/聚乙烯醇反应溶液中,通过缩醛化反应制得含Ag/SiO₂纳米颗粒的壳聚糖/聚乙烯醇海绵。检测材料的各项物理性能、表面形貌、细胞毒性、抗菌性能。 结果与结论：材料呈多孔结构,吸水率、透气性和保湿性良好,具有较高的拉伸强度;材料孔隙率高、空隙致密均匀,孔径大小为0.1~1 mm;MTT法检测材料对小鼠成纤维细胞毒性显示无明显毒性,并且能促进该细胞的生长;材料对金黄色葡萄球菌、大肠杆菌、白色念珠菌、铜绿假单胞菌、伤寒沙门菌均有良好的杀菌效果。以上结果显示材料不但具有良好的物理性能、生物活性和抗菌性能,而且合成工艺简单,可作为创面敷料。     

关于复方磺胺嘧啶锌凝胶(创必宁~)治疗烧烫伤及慢性创面临床共识(2014版)

烧伤创面及慢性创面易引起创面感染。理想的创面外用药需具有良好的广谱抗菌效果,不易产生耐药性,促进上皮细胞生长并保持创面湿润微环境等功效,还应具有止痛、使用方便等特点。复方磺胺嘧啶锌凝胶(创必宁)是由成都第一制药有限公司生产的外用锌银复合无菌制剂。其主要成分为2%磺胺嘧啶锌、1%磺胺嘧啶银、月桂氮酮、对羟基苯甲酸甲酯、海藻酸钠和葡萄糖酸钙。该制剂药理、毒理实验由解放军第三军医大学与华西医科大学基础医学院完成。临床研     

几种胶原型创伤敷料制作的实验研究

介绍了几各胶原型创伤敷料研制的方法。冷冻牛腱经０．０５Ｍ乙酸处理（ＰＨ３．２）４８－７２ｈ后，捣碎过滤、脱泡、加太酸软骨素（８％），制成１．５－２．５％胶原溶液。该溶液在预冷或不预冷的模具内冷冻干燥，冻干的胶的海绵在０．２５％戊二醛溶液中交联２４ｈ。并以类似的方法研制成聚氨酯膜－胶原海绵复合膜，涂聚氨酯胶原膜，和纱布胶原膜三种创伤敷料。结果表明冷冻牛腱胶原性能稳定，冻干的胶原海绵具有良好的孔洞结构     

纳米银缓释壳聚糖/聚乙烯醇伤口敷料的制备及表征

背景：临床上传统治疗创面感染主要使用抗生素药物敷料,但长期使用会诱导细菌耐药;同时纳米创伤敷料生物相容性差,无法降解,不宜长期覆盖创面。 目的：制备一种具有抗菌作用、生物相容性良好的伤口敷料,并表征分析其生物学性能。 方法：采用缩醛化反应制得含纳米银/聚乙二醇的壳聚糖/聚乙醇酸海绵,检测材料的物理性能、表面形貌、体外释放及抗菌性能。 结果与结论：制得的纳米银粒径小,分散性良好,体外释放实验表明纳米银粒子可持续不断地从辅料释放出来,作用于细菌。含纳米银/聚乙二醇的壳聚糖/聚乙烯醇海绵孔隙致密均匀,大小孔相互贯通;吸水性大、保湿性高、透气性适中;吸水率和透气率都随聚乙烯醇1799含量增加而增大;保湿率基本不变;对金黄色葡萄杆菌、大肠杆菌、白色念珠菌、铜绿假单胞菌、变伤寒沙门菌5种实验菌种均有良好杀菌效果。表明该敷料物理性能好,生物相容性及杀菌效果好。     

新型复合生物抗菌敷料的抗菌强度、吸湿能力及细胞毒性

背景：细菌感染是影响伤口愈合的主要因素之一,伤口渗出液里含有的大量炎症因子、蛋白酶和自由基都会减缓伤口的愈合速度。新型复合生物抗菌敷料的研发对治疗外科感染伤口有重要的意义,是创伤敷料发展的必然趋势。 目的：观察添加纳米银的海藻酸钙敷料的抗菌活性、吸湿能力及细胞毒性。 方法：将纳米银材料添加到海藻酸钙中制备新型复合生物抗菌敷料,并通过使用平板计数法、MTT法、电子显微镜观察法观察敷料的抗菌活性、吸湿能力及细胞毒性,再与银离子海藻酸钙敷料和海藻酸钙敷料进行对比,以期显示出新型复合生物抗菌敷料的具有强抗菌性及低细胞毒性的优势。 结果与结论：与银离子海藻酸钙敷料和海藻酸钙敷料相比,添加纳米银的新型复合生物抗菌敷料对金黄色葡萄球菌、铜绿假单胞菌均有更强的抑菌作用(P < 0.01),细胞毒性较低(P < 0.01);3种敷料的吸湿能力差异无显著性意义。证实此添加纳米银的海藻酸钙敷料的具有强抗菌性及低细胞毒性。      

Polyelectroylte complex composed of chitosan and sodium alginate for wound dressing application.

Drug-impregnated polyelectrolyte complex (PEC) sponge composed of chitosan and sodium alginate was prepared for wound dressing application. The morphological structure of this wound dressing was observed to be composed of a dense skin outer layer and a porous cross-section layer by scanning electron microscopy (SEM). Equilibrium water content and release of silver sulfadiazine (AgSD) could be controlled by the number of repeated in situ PEC reactions between chitosan and sodium alginate. The release of AgSD from AgSD-impregnated PEC wound dressing in PBS buffer (PH = 7.4) was dependent on the number of repeated in situ complex formations for the wound dressing. The antibacterial capacity of AgSD-impregnated wound dressing was examined in agar plate against Pseudomonas aeruginosa and Staphylococcus aureus. From the behavior of antimicrobial release and the suppression of bacterial proliferation, it is thought that the PEC wound dressing containing antimicrobial agents could protect the wound surfaces from bacterial invasion and effectively suppress bacterial proliferation. In the cytotoxicity test, cellular damage was reduced by the controlled released of AgSD from the sponge matrix of AgSD-medicated wound dressing. In vivo tests showed that granulation tissue formation and wound contraction for the AgSD plus dihydroepiandrosterone (DHEA) impregnated PEC wound dressing were faster than any other groups.     

Possibility of wound dressing using poly(L-leucine)/poly(ethylene glycol)/poly(L-leucine) triblock copolymer

ABA-type block copolymers (abbreviated as LEL) composed of poly(L-leucine) (PLL) as the A component and poly(ethylene glycol) (PEG) as the B component were synthesized by ring-opening polymerization of L-leucine N-carboxyanhydride initiated by primary amino group located at both ends of PEG chain. A silver sulfadiazine (AgSD)-impregnated wound dressing of sponge type was prepared by the lyophilization method. Morphological structure of this wound dressing by scanning electron microscopy was observed to be composed of a dense skin layer and a porous inner layer. Equilibrium water content of LEL wound dressing increased with an increase in PEG content in the block copolymer due to the hydrophilicity of PEG. AgSD release from AgSD-impregnated wound dressing in PBS buffer (pH = 7.4) was dependent on PEG content in the block copolymer. Release of AgSD was increased in proportion to the PEG content in the copolymer. Antibacterial capacity of AgSD-impregnated wound dressing was examined in agar plate against Pseudomonas aeruginosa and Staphylococcus aureus. It was found that the suppression of bacterial proliferation in the wound dressing was dependent upon the PEG content. In cytotoxicity test, cell damage did not occur by the release of AgSD from the LEL sponge matrix of AgSD-medicated wound dressing. In in vivo test, granulous tissue formation and wound contraction for the AgSD- and dehydroepiandrosterone-impregnated LEL-2 wound dressing were faster than for any other groups.     

LZB-GC纳米载银抗菌剂在藻酸盐印模材料中的抗菌性

背景：关于藻酸盐印模材料的消毒方法一直存在争议。 目的：分析LZB-GC纳米载银抗菌剂在藻酸盐印模材料中的最佳添加比例。 方法：将LZB-GC抗菌剂分别以0.125%,0.25%,0.5%,1%,1.5%,2%,2.5%的比例添加到藻酸盐印模材料中,以未添加LZB-GC抗菌剂的藻酸盐印模材料为对照,采用薄膜密着法测试其对金黄色葡萄球菌和大肠杆菌的抗菌性能。 结果与结论：随着LZB-GC抗菌剂添加量的增加,对金黄色葡萄球菌和大肠杆菌的抗菌率随之增大(P < 0.05),当添加量达到0.5%及以上,抗菌率可达到99%以上。说明LZB-GC抗菌剂在藻酸盐印模材料中的最佳添加比例为0.5%。     

Development of a Wound Dressing Composed of Hyaluronic Acid Sponge Containing Arginine and Epidermal Growth Factor

Hyaluronic acid (HA) has the ability to promote wound healing. Epidermal growth factor (EGF) is able to promote the proliferation of various cell types, in addition to epidermal cells. A novel wound dressing was designed using high-molecular-weight hyaluronic acid (HMW-HA) and low-molecular-weight hyaluronic acid (LMW-HA). Spongy sheets composed of cross-linked high-molecular-weight hyaluronic acid (c-HMW-HA) were prepared by freeze-drying an aqueous solution of HMW-HA containing a crosslinking agent. Each spongy sheet was immersed into an aqueous solution of LMW-HA containing arginine (Arg) alone or both Arg and epidermal growth factor (EGF), and were then freeze-dried to prepare two types of product. One was a wound dressing composed of c-HMW-HA sponge containing LMW-HA and Arg (c-HMW-HA/LMW-HA + Arg; Group I). The other was a wound dressing composed of c-HMW-HA sponge containing LMW-HA, Arg and EGF (c-HMW-HA/LMW-HA + Arg + EGF; Group II). The efficacy of these products was evaluated in animal tests using rats. In the first experiment, each wound dressing was applied to a full-thickness skin defect with a diameter of 35 mm in the abdominal region of Sprague–Dawley (SD) rats, leaving an intact skin island measuring 15 mm in diameter in the central area of this skin defect. Commercially available polyurethane film dressing was then applied to each wound dressing as a covering material. In the control group, the wound surface was covered with polyurethane film dressing alone. Both wound dressings (Group I and Group II) potently decreased the size of the full-thickness skin defect and increased the size of the intact skin island, when compared with the control group. The wound dressing in Group II showed particularly potent activity in increasing the distance of epithelization from the intact skin island. This suggests that EGF release from the spongy sheet serves to promote epithelization. The wound dressing in Group II enhanced early-stage inflammation after 1 week, as compared with the other two groups. In the second experiment, each wound dressing was applied to a full-thickness skin defect measuring 35 mm in diameter in the abdominal region of SD rats, after removing necrotic skin caused by dermal burns. Polyurethane film dressing was applied to each wound dressing as a covering material. In the control group, the wound surface was covered with polyurethane film dressing alone. Both wound dressings (Group I and Group II) potently decreased the size of the full-thickness skin defect and increased epithelization from the wound margin, as compared with the control group. The wound dressing in Group II was found to enhance early-stage inflammation after 1 week, as compared with the other two groups. The findings in both experiments indicate that the wound dressing composed of HA-based spongy sheets containing Arg and EGF potently promotes wound healing by inducing moderate inflammation. The release of EGF in the early stages of wound healing induces moderate inflammation. This suggests that wound healing is facilitated directly by topical application of EGF, and indirectly by cytokines derived from inflammatory cells stimulated by EGF.     

Electrospun mupirocin loaded polyurethane fiber mats for anti-infection burn wound dressing application

Wound care treatment is a serious issue faced by the medical staffs due to its variety and complexity. Wound dressings are typically used to manage the various types of wounds. In this study, polyurethane (PU) fibers containing mupirocin (Mu), a commonly used antibiotic in wound care, were fabricated via electrospinning technique. The aim of this study was to develop biomedical electrospun fiber scaffolds for preventing wound infections with good compatibility and to demonstrate their applications as anti-infective burn wound dressings. The surface morphology of fibers was obtained by scanning electron microscopy. FT-IR spectra, water vapor transmission rate, and drug release study in vitro were tested to demonstrate the fiber scaffold characteristic. The prepared PU/Mu composite scaffolds had satisfactory antibacterial activity especially against Staphylococcus aureus. The cell studies revealed that the scaffolds were biocompatible and safe for cell attachment. Histological and immunohistochemical examinations were performed in rats, and the results indicated the histological analysis of tissue stained with H&E showed no obvious inflammation reaction. The results indicated that the electrospun scaffolds were capable of loading and delivering drugs, and could be potentially used as novel antibacterial burn wound dressings.     

Development of a wound dressing composed of hyaluronic acid and collagen sponge with epidermal growth factor

This study was designed to investigate the effect of a wound dressing composed of hyaluronic acid (HA) and collagen (Col) sponge containing epidermal growth factor (EGF) on various parameters of wound healing in vitro and in vivo. High-molecular-weight (HMW) HA solution, hydrolyzed low-molecular-weight (LMW) HA solution and heat-denatured Col solution were mixed, followed by freeze-drying to obtain a spongy sheet. Cross-linkage between Col molecules was induced by UV irradiation to the spongy sheet (Type-I dressing). In a similar manner, a spongy sheet containing EGF was prepared (Type-II dressing). The efficacy of these products was firstly evaluated in vitro. Fibroblast proliferation was assessed in culture medium in the presence or absence of a piece of each wound dressing. EGF stimulated cell proliferation after UV irradiation and dry sterilization at 110°C for 1 h. In the second experiment, fibroblasts-embedded Col gels were elevated to the air-liquid interface to create a wound surface model, on which wound dressings were placed and cultured for 1 week. Cell proliferation and the production of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were investigated. With Type-II dressings, the amounts of VEGF and HGF released from fibroblasts in the Col gel were significantly increased compared with Type-I dressing. Next, the efficacy of these products was evaluated in vivo using Sprague-Dawley (SD) rats. Wound conditions after 1 and 2 weeks of treatment with the wound dressings were evaluated based on the gross and histological appearances. Type-II dressings promoted a decrease in wound size, re-epithelialization and granulation tissue formation associated with angiogenesis. These findings indicate that the combination of HA, Col and EGF promotes wound healing by stimulating fibroblast function.     

Assessment in vitro of the active hemostatic properties of wound dressings

The development of actively hemostatic wound dressings for use in severe trauma remains a major public-health and military goal. But, although some manufacturers claim that existing dressings activate platelets and/or blood coagulation, mechanistic evidence is often lacking. We describe a method for assessing the active hemostatic properties of dressings in vitro, entailing measurement of the flow of recalcified platelet-rich plasma (PRP) through a dressing sample. If the dressing is hemostatically active, flow is reduced. This flow is then compared with the flow-through of PRP in which both platelet and coagulation function are blocked with EDTA. The ratio of the two generates a hemostatic index that ranges from 1.0 (no active hemostasis) to 0 (highly potent). The method is applicable to porous or semiporous dressings, whether fabric, sponge, fleece, or granules. For an active dressing, the test is easily modified to differentiate between the contributions of platelet and coagulation to overall hemostasis. The method is illustrated for fabrics, over-the-counter gauze and sponge dressings, collagen-based sheets, and an absorbent granule dressing. One active collagen dressing is used to illustrate discrimination between platelet and coagulation function. The ability to assess hemostatic properties may significantly enhance the development of advanced active dressings.