上海交通大学学报(医学版) ›› 2022, Vol. 42 ›› Issue (5): 562-569.doi: 10.3969/j.issn.1674-8115.2022.05.002

• 论著 · 基础研究 • 上一篇    下一篇

制冷喷雾联合高分子水凝胶对急性烧伤创面的影响

董叫云(), 宋菲(), 陆树良, 刘琰(), 田鸣()   

  1. 上海交通大学医学院附属瑞金医院烧伤科,上海 200025
  • 收稿日期:2022-01-24 接受日期:2022-05-06 出版日期:2022-05-28 发布日期:2022-05-28
  • 通讯作者: 刘琰,田鸣 E-mail:dongjiaoyun@hotmail.com;fayex3@126.com。;ly10515@rjh.com.cn;tianming198@163.com
  • 作者简介:董叫云(1976—),女,主管技师,学士;电子信箱:dongjiaoyun@hotmail.com
    宋 菲女,主管技师;电子信箱:fayex3@126.com。第一联系人:(董叫云、宋 菲并列第一作者)
  • 基金资助:
    国家自然科学基金(81671916);上海市临床重点专科项目(shslczdzk02302)

Effects of cryogen spray combined with polymeric hydrogel on acute burn wounds

DONG Jiaoyun(), SONG Fei(), LU Shuliang, LIU Yan(), TIAN Ming()   

  1. Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
  • Received:2022-01-24 Accepted:2022-05-06 Online:2022-05-28 Published:2022-05-28
  • Contact: LIU Yan,TIAN Ming E-mail:dongjiaoyun@hotmail.com;fayex3@126.com。;ly10515@rjh.com.cn;tianming198@163.com
  • Supported by:
    National Natural Science Foundation of China(81671916);Shanghai Municipal Key Clinical Specialty(shslczdzk02302)

摘要:

目的·开发用于烧伤急救的、可快速降低皮肤温度并且对皮肤组织无刺激性的医疗用品——制冷喷雾剂和聚合物水凝胶。验证联合应用两者是否可快速阻断热源对皮肤组织的持续伤害,是否有利于创面的早期修复及降低烧伤创面的面积及深度。方法·将制冷液灌入高压罐中,评估制冷喷雾剂的制冷效果;制备水凝胶敷料,评估敷料的制冷时长;评估在大鼠背部皮肤连续使用制冷喷雾剂和水凝胶72 h后,对皮肤组织的刺激作用;建立大鼠烫伤模型,随机分为2组,每组6只,采用背部皮肤组织互相对比的方法,在烫伤区域使用制冷喷雾剂和水凝胶联合处理创面,分别与无处理组和自来水处理组做比较,24 h后评估烫伤部位的面积和创面炎症反应情况。结果·与普通自来水相比,15 %浓度的制冷喷雾剂的制冷效果最好,在3 min内,降温速度明显高于自来水对照组(P<0.05);水凝胶的冷却效果可维持8 h,可以在2 h内将70 ℃水的温度降至室温(22±2)℃,且水温全程低于对照组;2种材料对皮肤组织均无刺激性作用,未导致皮肤组织红斑、水肿等过敏反应。经制冷喷雾剂和水凝胶联合处理的烧伤创面,其焦痂面积显著减少,与无处理组及自来水处理组相比,均有统计学差异(P<0.05);H-E染色显示,与无处理组及自来水组相比较,联合应用制冷喷雾剂和水凝胶组的创面中,炎症细胞浸润的数量显著减少(P<0.05)。结论·制冷喷雾剂与聚合物水凝胶联合应用显示出良好的冷却效率,可减少焦痂面积、防止创面的不断加深及炎症细胞的聚集,有利于后期创面尽快愈合,且不会造成皮肤组织的过敏反应,可以作为烧伤患者急救管理的一种有效和方便的工具。

关键词: 烧伤, 急救, 制冷剂喷雾, 水凝胶

Abstract:

Objective·To develope a medical device for first aid of burns, a new formulation of cryogen spray and polymeric hydrogel, which can quickly reduce skin temperature and has no irritation, and investigate the effect of cryogen spray combined with polymeric hydrogel on quickly blocking the continuous injury of heat source to the skin tissue, and on the early repair of wound and reduction of the area and depth of burn wound.

Methods·The cryogen spray was filled into the high-pressure tank and its cooling performance was evaluated. Polymeric hydrogel dressing was prepared and the cooling time was evaluated. The irritating effect on rat' back skin tissue was evaluated after exploring on cryogen spray combined with polymeric hydrogel continuouly for 72 h. A burn rat model was created, the rats were randomly divided into two groups with 6 in each group. The burn area and inflammatory reaction of cryogen spray combined with polymeric hydrogel treated for 24 h was compared with that of the untreated group or the tap water treatment group.

Results·Compared with tap water, the cooling effect of 15% concentration cryogen spray was the best. Within 3 minutes, the cooling rate was significantly higher than that of the tap water control group (P<0.05). The cooling effect of polymeric hydrogel can be maintained for 8 h, the temperature of 70 ℃ water can be reduced to room temperature (22 ± 2) ℃ within 2 h, and the water temperature was lower than that of the control group throughout the whole process. Both materials had no irritating effect on skin tissue, and did not cause allergic reactions such as erythema and edema of skin tissue. Compared with the untreated group and the tap water group, the eschar area of the burn wound treated with cryogen spray combined with polymeric hydrogel decreased significantly (P<0.05). H-E staining showed that compared with the untreated group and the tap water group, the number of inflammatory cells in the wound of the combined application of cryogen spray and polymeric hydrogel group decreased significantly (P<0.05).

Conclusion·The combination of cryogen spray and polymeric hydrogel shows good cooling efficiency. The combined application can reduce the eschar area, and prevent the progressive deepening of the wound and the accumulation of inflammatory cells, which is conducive to the wound healing as soon as possible in the later stage. It will not cause allergic reaction of skin tissue. It may be exploited as an effective and convenient tool for the first aid management of burn patients..

Key words: burns, first aid, cryogen spray, hydrogel

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