金黄色葡萄球菌感染对部分缺血性切除皮肤伤口的影响

Advances in Medicine Pub Date : 2024-09-21 eCollection Date: 2024-01-01 DOI:10.1155/2024/2281747
Adrian E Rodrigues, David M Dolivo, Chun Hou, Yingxing Li, Lauren S Sun, Thomas A Mustoe, Seok Jong Hong, Robert D Galiano
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引用次数: 0

摘要

背景:皮肤伤口,无论是医学上的还是偶然造成的,总是有感染的风险,但当伤口在缺血、灌注不良的条件下恢复时,感染风险更大。经常感染皮肤和软组织的金黄色葡萄球菌在伤口灌注不良的情况下感染的几率更大。尽管这可能很糟糕,但金黄色葡萄球菌的 MSSA 和 MRSA 菌株都能引起严重感染,其中 MRSA 被认为更具侵袭性:在这项研究中,我们使用了一种袋鼠耳部切除伤口模型来初步测试部分缺血对未感染伤口愈合的影响。随后,我们在 MSSA 感染活跃的情况下测试了相同的缺血性损伤模型,并将这些伤口与正常灌注的 MSSA 感染伤口进行了比较。最后,我们测试了在相同的缺血模型下,MSSA 感染伤口和 MRSA 感染伤口的愈合是否存在差异:数据表明,部分缺血大大降低了非感染伤口的愈合(上皮间隙P=∗∗∗∗,肉芽间隙P=∗∗∗,肉芽面积P=∗∗∗∗)。同样,部分缺血伤口加上 MSSA 感染,与正常灌注下愈合的同类感染伤口相比,显示出愈合障碍(上皮间隙 P=∗,肉芽间隙 P=∗,肉芽面积 P=∗∗)。在缺血条件下愈合的 MSSA 感染伤口和 MRSA 感染伤口之间未观察到明显差异:数据显示了缺血和金黄色葡萄球菌感染导致的各种条件下伤口愈合的数量差异。虽然缺血和感染对伤口愈合有不利影响已是公认的事实,但通过测试这些条件,我们确定了这些情况对皮肤愈合的不利程度,从而为临床上遇到类似情况时提供了相对的比较和衡量标准。
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Influence of Staphylococcus aureus Infection on Partially Ischemic Excisional Skin Wounds.

Background: Skin wounds, whether medically or incidentally induced, are always at a risk of becoming infected, but the infection risks are greater when the wounds are recovering under ischemic, poorly perfused conditions. Staphylococcus aureus, which frequently infects cutaneous and soft tissue, can infect to a greater extent when wounds are poorly perfused. Bad as this may be, both MSSA and MRSA strains of S. aureus can cause severe infections, with MRSA being considered more aggressive.

Methods: In this study, we used a lagomorph ear excisional wound model to initially test the influence of partial ischemia on uninfected wound healing. We then subsequently test the same ischemic injury model under an active MSSA infection and compared these wounds against normally perfused MSSA-infected wounds. Lastly, we test whether differences in healing exist between MSSA-infected and MRSA-infected wounds, both under the same ischemic model.

Results: The data suggest that partial ischemia considerably reduces healing of noninfected wounds (epithelial gap P=∗∗∗∗, granulation gap P=∗∗∗, and granulation area P=∗∗∗∗). Similarly, partial ischemic wounds coupled with MSSA infection display healing impairments against likewise-infected wounds healing under normal perfusion (epithelial gap P=, granulation gap P=, and granulation area P=∗∗). No significant differences were observed between MSSA-infected and MRSA-infected wounds healing under ischemia.

Conclusion: The data produced quantitative differences in healing under various conditions consequent to ischemia and S. aureus infection. Although it is well recognized that ischemia and infection adversely influence healing, by testing these conditions, we determined the detrimental magnitude such circumstances inflict on skin healing, thereby providing a relative reference to compare and gauge when met with similar conditions clinically.

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