纳米银超声空化治疗实验性化脓性伤口的细胞学检查

P. Myronov, V. Bugaiov, O. Tymakova, M. Pogorielov, A. Opanasyuk
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引用次数: 1

摘要

化脓性伤口的治疗是现代外科的一个重要问题。细菌的抗生素耐药性大大降低了传统治疗方法的有效性。以往的研究表明,纳米银具有良好的抗菌活性,不会引起细菌耐药性。低频超声提高了纳米颗粒的杀菌性能,同时在清理脓坏死组织伤口和将纳米颗粒输送到感染部位方面发挥着重要作用。在化脓性伤口的治疗中,银纳米粒子的特性与低频超声的结合需要仔细研究。本研究的目的是通过细胞学检查证实纳米银和低频超声治疗化脓性伤口的有效性。材料与方法。本研究选用60只实验大鼠,平均分为3组。第一组采用低频超声治疗;在第二组中,银纳米粒子溶液与低频超声一起使用;对照组采用0.05%氯己定溶液。采用多元醇法制备了尺寸为10 ~ 60 nm的纳米银。研究显示,超声组、纳米银/超声组和氯己定组在第一天的差异无统计学意义。第3天,与第1天相比,纳米银/超声组的吞噬性中性粒细胞和成纤维细胞有统计学意义的增加。超声组和纳米银/超声组与氯己定组比较,单核细胞数量(2.2倍和4.2倍)和巨噬细胞数量(1.4倍和1.9倍)分别增加,细胞图坏死类型未确定。第7天,纳米银/超声组开始出现肉芽组织,白细胞破坏率下降了4.5倍,微生物几乎未检出,第一次出现再生型细胞图。对照组中性粒细胞数量是超声组类似参数的2.4倍,纳米银/超声组的3.8倍。与使用氯己定组相比,超声组(2.2倍)和银纳米颗粒/超声组(2.3倍)的成纤维细胞数量显著增加。第10天,对照组成纤维细胞和单核-巨噬细胞系列细胞数量增加,表明再生过程较晚。第10天,纳米银/超声组创面上皮形成完整,超声组创面愈合时间为第12天,对照组创面愈合时间为第21天。纳米银与低频超声联合应用可显著改善化脓性创面愈合的细胞学参数,较超声单一治疗和氯己定使用有明显优势。该方法缩短了治疗时间,有望应用于外科实践。
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CYTOLOGICAL EXAMINATION OF EXPERIMENTAL PURULENT WOUNDS IN THE TREATMENT OF SILVER NANOPARTICLES IN ULTRASOUND CAVITATION
The treatment of purulent wounds is an important problem of modern surgery. Antibiotic resistance of bacteria dramatically reduces the effectiveness of traditional methods of treatment. Previous studies have indicated that silver nanoparticles have good antibacterial activity and do not cause bacterial resistance. Low-frequency ultrasound improves the bactericidal properties of nanoparticles, as well as plays an important role in cleaning wounds from purulent-necrotic tissue and delivering nanoparticles to the site of infection. The combination of the properties of silver nanoparticles and low-frequency ultrasound requires careful investigation in the treatment of purulent wounds. The purpose of the study was to substantiate the effectiveness of the treatment of purulent wounds with silver nanoparticles and low-frequency ultrasound by cytological examination. Materials and Methods. This study was carried out on 60 laboratory rats, which were equally divided into 3 groups. In the first group, treatment was carried out by low-frequency ultrasound; in the second group, a solution of silver nanoparticles was used together with low-frequency ultrasound; in the third, control group, a 0.05% Chlorhexidine solution was used. Silver nanoparticles with a size of 10-60 nm were synthesized by the polyol method. Results. The study showed that there were no statistically significant differences between the ultrasound, silver nanoparticles/ultrasound and Chlorhexidine groups on the first day. On the third day, a statistically significant increase in phagocytic neutrophilic leukocytes and fibroblasts was observed in the silver nanoparticles/ultrasound group compared with the first day. In comparison with the Chlorhexidine group, the number of monocytes (2.2 and 4.2 times) and macrophages (1.4 and 1.9 times) increased in the ultrasound and silver nanoparticles/ultrasound groups respectively, and the necrotic type of cytograms was not determined. On the seventh day, granulation tissue began to appear in the silver nanoparticles/ultrasound group, the percentage of leukocyte destruction decreased (by 4.5 times), microorganisms were almost not detected, regenerative types of cytograms appeared for the first time. The number of neutrophils in the control group exceeded the analogous parameter of the ultrasound group by 2.4 times and the silver nanoparticles/ultrasound group by 3.8 times. The number of fibroblasts became significantly larger in the ultrasound (2.2 times) and the silver nanoparticles/ultrasound (2.3 times) groups, compared with the group where Chlorhexidine was used. On the tenth day, the number of fibroblasts and cells of the monocytic-macrophage series increased in the control group, which indicates later regenerative processes. On the tenth day, there was a complete epithelization of wounds in the silver nanoparticles/ultrasound group, while healing occurred on day 12 in the ultrasound group, and on day 21 in the control group. Conclusions. The combined use of silver nanoparticles and low-frequency ultrasound significantly improves the cytological parameters of wound healing of purulent wounds and has clear advantages over the ultrasound monotherapy and the use of Chlorhexidine. The presented method reduces the treatment time and can be prospectively introduced into surgical practice.
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