Abstract
Objective To explore the effect and mechanism of the sponge dressing on the healing of refractory orthopedic wound, and the gelatin-Bletilla striata gum/Salvia miltiorrhiza nano Ag (GBS-Ag) sponge dressing was prepared. Methods GBS-Ag sponge dressing was prepared by the freeze-drying method. Twenty male SD rats were randomly divided into the control group (Ctrl group) and GBS-Ag group, with 10 rats in each group, and the rats in the two groups were established a model of back wound infection. The Ctrl group was treated with gauze, while the GBS-Ag group was treated with GBS-Ag sponge dressing. Wound healing rate, blood immune indexes, Ag content in each organ, morphological changes of wound, and expression of transforming growth factor-β1 (TGF-β1) in wound transformation were detected in the two groups of rats. Results The mechanical properties of GBS-Ag sponge dressing were all in line with the standard, and it had good killing effect on the conventional strain after being incubated for 24 hours. Compared with the Ctrl group, the healing rate and lymphocyte percentage in the GBS-Ag group were significantly increased on day 4 and day 10 (P < 0.05), while the total number of white blood cells and the percentage of neutrophils were significantly decreased (P < 0.05). Compared with Ctrl group, the Ag content in liver, spleen, and kidney of rats in the GBS-Ag group was significantly increased (P < 0.05). The histological results showed that the Ctrl group lacked collagen fibers in the dermis, and the angiogenesis was not rich, accompanied by a large number of inflammatory cell infiltration. The epidermal repair of rats in the GBS-Ag group was complete and partially keratinized, the dermis was rich in collagen fibers, with elastic fibers and new blood vessels, inflammatory cells were rare, and new hair follicles and thick-walled blood vessels were also observed. The expression of TGF-β1 protein in the wounds of rats in the GBS-Ag group was higher than that of the Ctrl group. Conclusion GBS-Ag sponge dressing had multiple effects of sterilization and promoting wound healing, and its mechanism may be related to promoting the TGF-β1 protein expression.
Highlights
The healing of refractory wounds caused by large area soft tissue injury in orthopedics is a complex process, which is a dynamic process involving cells, biochemical reactions, and various enzymes, which run through the whole process of skin injury until the wound is completely healed [1]
Preparation of gelatin-Bletilla striata gum/Salvia miltiorrhiza nano Ag (GBS-Ag) Sponge Dressing (I) Preparation of sponge matrix solution was as follows. 3% chitosan solution: 3 g chitosan was added to 100 mL 1% glacial acetic acid solution, stirred, mixed, and filtered; 4% polyvinyl alcohol solution: 4 g polyvinyl alcohol was added to 100 mL distilled water, swelled for 30 min, stirred and mixed in a water bath pot above 50°C, and filtered; chitosan-polyvinyl alcohol mixture was obtained by mixing 3% chitosan solution and 4% polyvinyl alcohol solution at 1 : 1 volume ratio (II) Preparation of nano Ag solution was as follows
After 24 hours of incubation, they increased to (12:5 ± 2:7) mm, (11:5 ± 2:6) mm, (10:5 ± 1:3) mm, and (15:9 ± 1:5) mm, respectively. Compared with those at 0 h of incubation, the diameter of the bacteriostatic ring produced by Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans at 24 h increased considerably
Summary
The healing of refractory wounds caused by large area soft tissue injury in orthopedics is a complex process, which is a dynamic process involving cells, biochemical reactions, and various enzymes, which run through the whole process of skin injury until the wound is completely healed [1]. Wound healing can be divided into four stages: hemostasis, inflammation, proliferation, and regeneration. These stages occur in an orderly manner and promote wound healing and reduce scarring [2]. When the proliferation of microorganisms in the wound reaches a certain level, it will become infected, which will cause local inflammatory reaction and signs of systemic infection, leading to general functional decline and secondary injury of the wound, increase the difficulty of wound healing, and even cause systemic diseases. The other factor is the blood supply to the wound tissue, which provides nutrients, inflammatory cells, and oxygen to the wound
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