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Objective@#To evaluate the outcome of negative pressure closed drainage with chitosan membrane in the treatment of multiple drug-resistant bacterial infections.@*Methods@#From January 2015 to December 2017, 108 patients with skin ulcer wound complicated by multiple drug-resistant bacterial infection were admitted in the department of burn and plastic surgery, Qingdao Jiaozhou Central Hospital. Among them, 36 patients had pressure ulcers, 40 cases had diabetic foot wounds, and 32 were traumatic skin ulcer wounds. Patients were divided into group A or group B for different treatments. In group A, besides the basic surgical dressing change, patients were treated by negative pressure closed drainage with chitosan membrane. The patients in Group B were only treated with basic surgical dressing change. The changes of wound were closely observed during the phases, and the wound bacterial culture and antimicrobial drug sensitivity test were performed regularly. The therapeutic effects of the 2 groups were compared. The changes of bacterial species of wound infection and the healing time were recorded.@*Results@#In group A, the healing time of wound infection was: pressure ulcers (14.00±1.28) days, diabetic foot wounds (13.40±1.27) days, traumatic skin ulcer wounds (12.44±1.55) days. In group B, the wound healing time was: pressure ulcers (25.17±2.73) days, diabetic foot wounds (23.85±1.73) days, traumatic skin ulcer wounds (19.81±1.94) days. The wound healing time of group A was shorter than group B. In group A, the multiple drug-resistant bacteria was replaced by non-multiple drug-resistant bacteria, or there was no pathogenic bacterial growth. The differences between the two groups was statistically significant (all P<0.05).@*Conclusions@#Additional to the basic surgical dressing change, negative pressure closed drainage with chitosan membrane could promote wound healing, when it′s associated with multiple drug-resistant bacteria infection. This method has benefits in efficient drainage, preventing the formation of bacterial biofilm and changing local microenvironment for the dominant propagation. Therefore, it could effectively control the multiple drug-resistant bacterial infections, promote wound healing and save treatment time.
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Objective To investigate the promoting repair effects of chitosan/gelatin electrospinning membrane implantation on conjunctival injury.Methods Chitosan/gelatin electrospinning membrane was prepared using electrospinning technique,and the general characteristics of the membrane was examined under the scanning electron microscope.Conjunctival injury models were established in the right eyes of 30 New Zealand white rabbits by surgical resection of 6 mm×8 mm bulbar conjunctiva,bums of weak acid at injury site and then randomized into model group,human amniotic membrane (AM) implanted group and electrospinning membrane implanted group.AM or electrospinning membrane was interlayerly implanted between conjunctiva and sclera during operation according to grouping.The inflammatory response and histopathological change at injury site were examined by slit lamp microscope and optical microscope in 4,8,14 and 28 days after surgery.The use and care of the animals followed by code of ethics for animal experiments at the animal experiment center of He University.Results Chitosan/gelatin electrospinning membrane presented with a crosslinked network structure like AM,with the nano-microstructure of 0.1-0.5 μm fibre.No obvious inflammatory symptom was seen in the experimental eyes of various groups in 4 days after operation.In 8 days after operation,conjunctival edema and erosion were found in the model group,and slight conjunctival congestion was exhibited in the eyes of AM implanted group and electrospinning membrane implanted group.In 14 to 28 days after operation,conjunctival edema and new blood vessels were seen in the model group,and the conjunctivas were well recovered in the AM implanted group and electrospinning membrane implanted group.Histopathological examination showed dissociation,attaching,thickening and epithelization of injuried conjunctivas gradually in the model group from 4 to 28 days after operation.In the AM implanted group,attaching of AM was in 4 days,melting of AM was in 8 days,epithelization of injuried conjunctivas was in 14 days and renovation of conjunctivas was in 24 days after operation,and a rapid repairing procedure was found in the electrospinning membrane implanted group under the optical microscope.Conclusions Compared with the self-repairing process of conjunctival injury,implantion of chitosan/gelatin electrospinning membrane or AM can speed up the renovation of injuried conjunctivas,and the effects of chitosan/gelatin electrospinning membrane are better than those of AM in promoting conjunctiva repair and inhibiting scarring.
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Objective To prepare and characterize nanoparticles in-loaded one-way release-controlled chitosan membrane,and to explore the release-controlled rule of the film in vitro.Methods The chitosan nanoparticles were prepared by inverse crosslinking-emulsion method.The one-way release-controlled membrane was prepared by a casting method.Transmission electron microscope (TEM) was used to evaluate the morphological properties and particle size analyzer was used to analyze particle size distribution.The morphology of the membrane was inspected through scanning electron microscope (SEM).MTT assay was applied to determine the biological safety of chitosan nanoparticles.The distribution of the nanoparticles was observed by fluorescence microscope.The in vitro release studies were adopted to evaluate the release-controlled rule.Results The four kinds of nanoparticles had spherical shapes and uniform particle size.The size of the hyaluronic acid-coated chitosan nanoparticle was (255.40±39.10) nm.Hyaluronic acid-coated chitosan nanoparticles showed the best property of sustained release and biocompatibility.The membrane had a loose inner layer and a dense outer layer,and the distribution of the nanoparticles was uniform in the inner layer of the membrane.The release of protein from membrane was unidirectional and the membrane displayed good controlled release property.Conclusions The nanoparticles in-loaded one-way release-controlled chitosan membrane presents good one-way sustained release performance.It is potentially useful in delivery system of growth factors.
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This study was designed to compare the effects of treatment using chitosan membrane (Nanogide-C(R)) resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, Biomesh(R)). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.
Subject(s)
Humans , Chitosan , Furcation Defects , Gingival Recession , Guided Tissue Regeneration , MembranesABSTRACT
The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mmx4mm) on dorsal side of Sprague Dawley rat, and sacrificed them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76+/-2.37mm2, 4.91+/-1.06mm2, 4.90+/-0.98mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6+/-4.5%, 52.8+/-9.4%, 56.4+/-5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62+/-0.82mm2, 3.63+/-0.76mm2, 4.07+/-1.14mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1+/-5.8%, 30.9+/-3.4%, 29.2+/-3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96+/-1.05mm2, 4.77+/-0.76mm2, 3.86+/-0.84mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7+/-5.1%, 53.3+/-4.4%, 69.5+/-3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resoption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01+/-2.01mm2, 5.49+/-1.3mm2, 5.06+/-1.38mm2 at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3+/-3.6%, 38.4+/-3.8%, 39.7+/-5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.
Subject(s)
Animals , Rats , Absorption , Chitosan , Connective Tissue , Membranes , Periodontal Diseases , Regeneration , Space Maintenance, Orthodontic , Wound HealingABSTRACT
Using the rat's skull, the study on the biodegradability and guided bone regeneration of the chitosan membrane was performed. The results are as follows: 1. The biodegradability of the chitosan membrane could not be confirmed, but after 12 weeks, this membrane did not yet break into small pieces and there was no specific local tissue reaction. 2. It was not certain whether the pore size of this membrane was affected on osteoblastic activity. 3. After 6 weeks, the bony defect area of rat's skull was not completely filled, but on high magnification it showed that the osteoclasts and the osteoblasts were observed in the regenerating area. In conclusion, the chitosan membrane developed in this study was fit for guided bone regeneration.