A combination of pure hypochlorous acid solution 0.01% as the irrigation solution and NPWT was used to treat a patient with acute necrotizing fasciitis. A line diagram of the equipment is shown on Figure 1. Before treatment, the wound area was cleansed, the wound debrided, and the skin dried. A foam dressing (V.A.C. GranuFoam, KCI, San Antonio, TX) was sized and placed in the wound. A separate inflow tube (ie, an intravenous extension with a port) was placed on and through the foam. The adhesive drape was attached and placed over the entire area, including the foam. The area around the tubing was sealed with a skin barrier ointment (Stomadhesive Paste, ConvaTec, Skillman, NJ). The NPWT device was then turned on and adjusted from 50-125 mm Hg suction. The irrigation solution (5 mL) was instilled via syringe through the inlet-port into the wound bed with the vacuum turned on (Figure 2). Activity of the irrigation solution against alpha-hemolysin toxin of S. aureus was tested by cytotoxicity assay. Human lung epithelial cells (A549, ATCC CCL 185) were grown in F12K cell culture medium supplemented with 10% fetal bovine serum (Life/Invitrogen, Carlsbad, CA) and 100 IU/mL penicillin/100 µg/mL streptomycin (Mediatech Inc, a Corning subsidiary, Manassas, VA). Assays were performed using F12K medium with different concentrations of purified toxin by measuring the reduction of MTS tetrazolium compound into formazan that is soluble in cell culture medium. On the day before the assay, 5000 cells/well were seeded in a flat-bottom 96-well plate. One ug/mL alpha-hemolysin toxin (Sigma Aldrich, St. Louis, MO) from S. aureus was incubated with a series of irrigation solution dilutions for 1 hour. Excess irrigation solution was inactivated by adding an equal volume of 20 mM methionine for 1 hour at room temperature and added to the cells for 16 hours at 37°C with 5% CO2. At the end of the experiment, cell viability was determined with an assay (CellTiter 96 AQueous One Solution Cell Proliferation Assay [MTS], Promega, Madison, WI). Inactivation of streptokinase was determined by clot formation enzymatic assay (Sigma Aldrich, St. Louis, MO), whereby thrombin converts the soluble fibrinogen into soluble fibrin. In the presence of streptokinase enzyme from S. pyogenes, the insoluble fibrin is converted into soluble fibrin fragments. Several hours before the study, streptokinase (175 U/mL) was incubated with the irrigation solution for 1 hour, followed by inactivation of excess irrigation solution by adding an equal volume of 20 mM methionine for 1 hour at room temperature. In a separate glass tube, fibrinogen solution containing borate buffer, gelatin diluent, and plasminogen were mixed by swirling, and then equilibrated at 37° C for 3 minutes. Irrigation solution and methionine-treated streptokinase was added to the solution, mixed by swirling, and equilibrated at 37° C for 1 minute prior to the addition of thrombin. The solution was mixed by swirling and equilibrated at 37° C for approximately 2-3 minutes to allow for clot formation. A 4 mm glass bead was added to the top of the reaction mixture, and the time for the glass bead to touch the bottom of the tube was observed.
- See more at: http://www.woundsresearch.com/article/treatment-acute-necrotizing-fasciitis-using-negative-pressure-wound-therapy-and-adjunctive-n#sthash.VzB7Pyak.dpuf
一個組合的純次氯酸酸解決0.01%的灌溉的解決辦法和npwt是用來治療病人的急性足多。 一個路線圖的裝備是顯示於圖1。 治療前,傷口的領域是清洗,傷口debrided、皮膚乾燥。 一個泡沫選礦(V.A.C. granufoam、裝、San Antonio,TX)的大小和放置在傷口。一個單獨流入管(IE,一個與靜脈延長一個端口)放在和通過的泡沫。 德拉佩的粘附和放在整個地區,包括泡沫。 該區附近的管材是密封的皮膚障膏(stomadhesive膏、convatec、希爾曼,NJ)。 《npwt設備,然後打開和調整至50-125毫米汞Hg吸。灌溉的解決辦法(5毫升)是通過注射器通過注入的進水口的端口的傷口床的真空,打開(圖2)。 活動的灌溉解決對阿爾法-hemolysin毒素,S.葡萄球菌是測試的細胞含量。 人類龍上細胞(a549應急信貸額度,中心185)是生長在f12k細胞培養基輔以10%胎兒牛血清(生活/invitrogen,斯、CA)和100IU/ml青霉素/100g/ml鏈(mediatech INC,一個科寧附屬、馬納薩斯,Va)。 化驗所進行使用f12k中等與不同濃度的淨化毒素的測量,減少MTS性四氮唑復合成formazan即溶在細胞培養基。 此前一天的含量,5000細胞/好種子是在一個平底板96-好。 一個微克/毫升alpha-hemolysin毒素(西格瑪Aldrich,聖路易斯、MO)從S葡萄球菌孵化,是一系列的灌溉解決液,1小時。 超過灌溉的解決辦法是停止生產量增加了一個平等的20毫米蛋氨酸,1小時在室溫的細胞和由為16小時37C,5%CO2。在這次試驗,細胞上的可行性的決心,一個含量(celltiter96水汽一個解決方法細胞擴散含量[MTS]將、麥迪遜WI)。 ”,他們是由血栓形成酶含量(西格瑪Aldrich,聖路易斯、MO),據此thrombin轉換的溶型入水溶性纖維。 在他們酶從S.
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