Negative pressure wound therapy decreases mortality in a murine model of burn-wound sepsis involving Pseudomonas aeruginosa infection.
Negative pressure wound therapy decreases mortality in a murine model of burn-wound sepsis involving Pseudomonas aeruginosa infection.
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DOI：
10.1371/journal.pone.0090494
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Hu D
中科院分区：
文献类型：
--
作者：
Liu Y;Zhou Q;Wang Y;Liu Z;Dong M;Wang Y;Li X;Hu D
铜绿假单胞菌在烧伤创面的定植可导致感染性休克、器官损伤和高死亡率。我们假设负压伤口治疗（NPWT）可减少烧伤伤口内铜绿假单胞菌的侵袭和增殖，并降低死亡率。在麻醉小鼠中诱导热损伤，并将铜绿假单胞菌应用于伤口表面24 h。去除烧伤焦痂和清创后，对动物进行NPWT或湿转干（WTD）治疗方案。在7天的治疗过程中，伤口表面上的细菌负荷进行了评估，作为外周血样本中的炎性细胞因子的浓度。烧伤诱导后每天监测存活率，持续14 d。最后，收集受伤的皮肤、肺、肝和肾的样品并进行组织病理学检查。将铜绿假单胞菌应用于烧伤创面导致脓毒症。在治疗的早期阶段，与WTD治疗的动物相比，NPWT降低了脓毒症动物的死亡率和烧伤伤口内的铜绿假单胞菌水平。通过NPWT，循环细胞因子水平和细胞结构异常也显著降低。我们的数据表明，NPWT可抑制烧伤组织中铜绿假单胞菌的侵袭和增殖，并降低烧伤脓毒症小鼠模型的早期死亡率。这些治疗受益可能是由于NPWT能够减少伤口表面的细菌增殖、降低细胞因子血清浓度并防止内脏器官损伤。
The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD) treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination. Applying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT. Our data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs.