细菌生物膜对慢性伤口的影响及防治策略

Effects of bacterial biofilm on chronic wound healing and its treatment strategy

背景:了解细菌生物膜的形成及对伤口愈合的影响机制,防止细菌生物膜对伤口愈合的影响,对于提高慢性伤口的治愈率有重要作用。目的:综述细菌生物膜对慢性伤口的影响机制,以及现有的治疗护理对策。方法:应用计算机检索Springerlink及CNKI数据库2008至2013年发表的文章,检索关键词为"细菌生物膜,慢性伤口感染;bacterial biofilm,Chronic wound infection"。选取与伤口感染、细菌生物膜相关的治疗及护理方面相关的文章。结果与结论:大量研究证实,致病菌或机会致病菌引起的慢性感染常与生物膜形成相关,细菌生物膜形成是导致慢性伤口难以愈合的重要因素之一。生物膜形成机制复杂。目前主要通过规范操作及环境管理、合理使用抗生素、及时清创来预防细菌生物膜的形成。针对细菌生物膜的治疗主要有超声治疗、负压治疗、噬菌体疗法、乳铁蛋白、硝酸镓、乙二胺四乙酸、木糖醇、蜂蜜、中药、高压氧治疗等。

BACKGROUND： Understanding the formation of bacterial biofilm and the mechanism of bacterial biofilm on wound healing, and preventing the influence of bacterial biofilm on wound healing, play a crucial role on improving the healing rate of chronic wounds. OBJECTIVE： To review the mechanism of bacterial biofilm on wound healing, and the current nursing strategy. METHODS： A computer-based retrieval of Springedink and Chinese National Knowledge Infrastructure （CNKI） database was performed for articles published between 2008 and 2013. The key words are ＂bacterial biofilm, chronic wound infection＂ in English and Chinese. Articles about the wound infection nursing and bacterial biofilm treatment were reviewed. RESULTS AND CONCLUSION＂ Growing evidence have shown that, pathogenic bacteria or opportunistic pathogen caused chronic wound infection is related to the formation of bacterial biofilm, which is one of the most important reasons of chronic wound non-healing. The mechanism of the bacterial biofilm formation is complicated. Standard procedure, environmental management, rational use of antibiotics, timely debridement can prevent the formation of bacterial biofilm. Treatment methods for preventing the formation of bacterial biofilm include ultrasonic treatment, negative pressure treatment, phage therapy, lactoferrin, gallium nitrate, ethylenediamine tetraacetic acid, newtol, bee honey, traditional Chinese medicine, hyperbaric oxygen therapy and so on.