Methylene blue mukutsvakurudza maronda: zvifukidzo, chiedza, nemigumisiro yekupora

Bhandiji rakasvibiswa nedhayi yebhuruu nebhodhoro rine donhodzo remvura yebhuruu zvinoita senzira imwe chete yekurapa. Mukutsvakurudza maronda hazvina kufanana. Chimwe chifukidzo cheronda chakagadzirwa chine huwandu hwedhayi hwakatarwa, chinoedzwa sechishandiso chakapedzwa kugadzirwa. Chimwe musanganiswa wemvura nedhayi unoiswa nemaoko, umo kusimba kwemusanganiswa, huwandu hwemvura, uye nguva yekubata ronda zvinosiyana pakuisa kwega kwega. Zvidzidzo zvezvinhu izvi zviviri zvinopindura mibvunzo yakasiyana, uye zviyero zvemigumisiro yazvo zvinosiyanawo.

Ongororo iyi inochengeta zvinhu izvi zviviri zvakaparadzana. Inoratidza zvakaiswa nevatsvakurudzi, kwavakazviisa, uye zvavakayera: ukuru hwenzvimbo yeronda, kumhanya kwekuvharika kwaro, nhamba yemabhakitiriya, kana chiyero chemurabhoritari chinomirira kupora chakadai sekuvharika kwemukaha wakakwenywa mundiro.

Mamiriro matatu, akatsanangurwa zviri nyore

Tsvakurudzo yemaronda inoshandisa methylene blue inowira mumamiriro matatu. Imwe neimwe ine pfungwa yayo yezvinoitwa nedhayi.

Chekutanga, zvifukidzo zvefuro zvine madhayi. Zvigadzirwa zvakadai sefuro repolyvinyl alcohol rakazadzwa nemethylene blue negentian violet (rinotengeswa seHydrofera Blue antibacterial foam) zvine madhayi akasungirirwa muchimiro chechifukidzo. Mashandiro anotaurwa ndeekurwisa mabhakitiriya kwakabatana nechifukidzo, kunotarisirwa kubatsira kudzora huwandu hwemabhakitiriya munzvimbo yeronda uku furo richibata mvura inobuda muronda. Sarudzo dzekurapa nechigadzirwa chakadaro ndedzemushandi wezveutano anosarudza chifukidzo cheronda rakati; mirayiridzo yechifukidzo ndiyo inotsanangura nguva yachinofanira kugara chiri paronda uye kuti chinotsiviwa kangani, kwete nzira inoshanda kune dhayi yebhuruu yose.

Chechipiri, kurapa kwephotodynamic nemethylene blue. Pano musanganiswa wemethylene blue unoiswa sechinhu chinonzwa chiedza, wobva wavhenekerwa, kazhinji nechiedza chitsvuku chiri pedyo nenzvimbo iyo dhayi inonyanya kunwa chiedza. Chiedza neokisijeni zvinobatsira kugadzira zvinhu zvinokurumidza kuita makemikari zvinokuvadza tupukanana. Makemikari aya anoshanda zvakasiyana nepfungwa yekudzivirira oxidation inoshandiswa pakushambadza zvekuchengetedza ganda, musiyano unotsanangurwawo mugwara redu remethylene blue mukuchengetedza ganda. Nzira iyi inosanganisa dhayi, mwero wechiedza, neokisijeni, uye kuchinja chimwe chezvitatu izvi kunochinja nzira yacho.

Chechitatu, methylene blue isina chiedza mumasero nemumhuka. Zviedzo izvi zvinobvunza kana dhayi pachayo ichichinja maitiro emasero efibroblast, mapuroteni echimiro chinotsigira masero, kana kuvharika kwemaronda akagadzirwa pakuedza. Izvi zvidzidzo zvemashandiro, kwete zviedzo zvezvifukidzo zvemaronda.

Mepu yezvidzidzo nemienzaniso: chii chakaedzwa, pachii, uye chii chakachinja

Shandisa tafura iyi semepu yechinyorwa. Verenga mutsetse mumwe nemumwe kubva kuruboshwe kuenda kurudyi: chinhu chakashandiswa, muenzaniso, uye mugumisiro unogona kutsigirwa nemutsetse iwoyo. Hapana mutsetse unotora mugumisiro wemumwe.

Zvifukidzo: chishandiso chakapedzwa kugadzirwa, kwete resipi yedhayi

Zvifukidzo zvefuro zvakadzidzwa mukutarisira maronda zvishandiso zvinogadzirwa. Mhando dzeHydrofera Blue dzinotsanangurwa papeji rechigadzirwa remugadziri dzinosanganisa madhayi maviri mufuro risina utachiona: mhando yeCLASSIC yepolyvinyl alcohol ine dhayi imwe neimwe isingapfuuri 0.00025 g pagiramu refuro, uye mhando yeREADY yepolyurethane ine isingapfuuri 0.00035 g pagiramu. Sezvo madhayi achiiswa panguva yekugadzira, chifukidzo chimwe nechimwe chine huwandu hunozivikanwa, uye mishumo yezvekurapa inotsanangura chigadzirwa nezita, nguva yachinogara chiri paronda, uye hurongwa hwekuchitsiva.

Izvi zvishandiso zvekurapa zvakapiwa mvumo yekutengeswa, kwete mishonga yakabvumidzwa. Chifukidzo chekutanga chine mvumo yeFDA K013462 ya2002, mhando yeHydrofera Blue yepolyurethane ine mvumo K130670 ya2014, uye mhando yeREADY ine mupendero ine mvumo K190268 ya2019. Mvumo kuburikidza nenzira ye510(k) inosimbisa kufanana kwakakura nechishandiso chakambovapo; haisi mvumo inosimbisa kushanda kwacho mukurapa. Zvinotaurwa nezvekurwisa tupukanana mumagwaro echishandiso zvinonyanya kutsamira pakushanda mukati mechifukidzo uye mukuedzwa murabhoritari, izvo zvisingafaniri kushandurwa kuva chirevo chekuti chifukidzo chinobvisa utachiona hwose mumatishu ane utachiona nemwero wakatarwa wekuderedza we log.

Ruzivo rwekurapa rwakabudiswa runonyanya kuva mapoka madiki asina mapoka ekuenzanisa. Muchidzidzo chakatevera maronda 29 enguva refu chakaitwa naWoo naHeil, Hydrofera Blue Classic yakatsiviwa katatu pavhiki kwemavhiki mana, avhareji yeukuru hwenzvimbo yeronda yakaderera kubva pa21.4 kuenda pa12.3 cm² (kuderera kwe42.5%) uye zvibodzwa zvePUSH zvakaderera kubva pa13.3 kuenda pa10.7. Boka renyaya dzemaronda 15 emakumbo rakatsvakurudzwa naCoutts, Ryan naSibbald rakaona ukuru hweronda huchiderera pamavhiki mana mumaronda 8 pa14 aikwanisa kuongororwa, uye kurwadziwa kuchidzikira mune vamwe varwere, kunyanya vaiva nemaronda etsoka ane chekuita nechirwere cheshuga. Chidzidzo chakatarisa kumashure boka remaronda 53 chakataurwa naLullove chakasanganisa furo nechimiro chinotsigira masero chakagadzirwa necollagen yehwai, saka avhareji yekuderera kwenzvimbo ye91.3% pamavhiki gumi nemaviri haigoni kunzi yakakonzerwa nefuro chete. Ongororo huru yepurogiramu yakatarisa kumashure yakaitwa naHurd yakashuma kupora kwakakurumidza uko zvifukidzo zvakashandiswa mukati mehurongwa hwakafanana hwekupa rubatsiro, izvo zvakare zvinoedza hurongwa hwose kwete dhayi.

Pane chipingamupinyi chimwe chinowanikwa mune zvose izvi: huwandu hwemabhakitiriya hunoratidzwa sezvibodzwa zvezviratidzo zveutachiona pakuongororwa kana sampuli dzinotorwa nekukwiza dzinongofungidzira huwandu, kwete kuyera huwandu kuburikidza nekukudza tupukanana twematishu kakawanda. Pfupiso yakatendeseka ndeyekuti zvidzidzo zvefuro rine madhayi maviri zvinotaura kuderera kwenzvimbo yeronda, kuvandudzwa kwezvibodzwa zvepasi peronda, uye dzimwe nguva kuderera kwekurwadziwa, pasina kusimbisa hukama pakati pehuwandu hwemethylene blue nemugumisiro wayo kana mwero wakayerwa wekuuraya mabhakitiriya mumatishu. Uye hapana chinhu muzvidzidzo zvezvifukidzo chinoratidza kuti kunyudza gauze mumusanganiswa unobva mubhodhoro rine donhodzo kunoenzana nazvo. Kusimba kwemusanganiswa, kuparadzirwa, kumhanya kwekuburitswa kwedhayi, kusava neutachiona, uye nguva yekugara paronda zvose zvinosiyana.

Chiedza pamwe nedhayi: zvidzidzo zvemaronda zvephotodynamic

Tsvakurudzo yemaronda yephotodynamic inowedzera kuvhenekera muhurongwa hwayo. Kusimba kwemisanganiswa muzvidzidzo zvevanhu kunowanzova pakati pe0.01% ne1% methylene blue, nechiedza chitsvuku chiri pedyo ne635 kusvika 660 nm uye simba rechiedza pachikamu chenzvimbo kubva pamajoule mashoma pasikweya sentimita kusvika kune anopfuura zana. Mapoka ekuenzanisa anosiyana: zvimwe zvidzidzo zvinoenzanisa nekutarisirwa kunowanzoitwa, zvimwe zvinoshuma nhamba yemabhakitiriya mumaronda mamwe chete nzira isati yashandiswa uye mushure mayo.

Zviratidzo zvinowanzodzokororwa muzvidzidzo zvevanhu zvine chekuita nemamiriro eronda neukuru hwenzvimbo yaro pane nhamba yemabhakitiriya. Muchidzidzo chine boka rekuenzanisa chemaronda 12 ane chekuita nechirwere cheshuga chakaitwa naCarrinho nevamwe, 0.01% methylene blue pamwe nechiedza che660 nm pamwero we6 J/cm², katatu pavhiki kwezvikamu gumi, zvakapa kuderera kwenzvimbo yeronda kwakakura zvakakosha pakuongorora nhamba kupfuura kurapa kweboka rekuenzanisa. Boka renyaya dzemaronda mashanu ane utachiona rakatsvakurudzwa naShen nevamwe rakashuma kupora kwakazara mushure meavhareji yezvikamu zvina zve1% dhayi nechiedza che635 nm, pasina zviyero zvehuwandu hwemabhakitiriya. Chiedzo chikuru pane zvose chine kugoverwa zvisina kurongwa kusvika zvino, chiedzo chevanhu 94 chemaronda etsoka ane chekuita nechirwere cheshuga umo varwere nevatsvakurudzi vakanga vasingazivi mapoka acho, chakaitwa naChagas nevamwe, chakaona zvibodzwa zvemaronda zveBates-Jensen zvichivandudzika kubva pachikamu chechitatu kusvika pakuteverwa kwemazuva makumi matatu ne1% dhayi pamwe nelaser ye660 nm, pasina zviitiko zvinokuvadza zvine chekuita nekurapa, asi zvakare pasina chiyero chehuwandu hwemabhakitiriya.

Yambiro mbiri dzinochengeta zvinyorwa izvi zvakatendeseka. Chekutanga, mugumisiro mukuru une chekuita nekudimburwa kwenhengo dzomuviri unombotaurwa kubva kuna Tardivo nevamwe wakashandisa methylene blue yakasanganiswa netoluidine blue, saka haugoni kunzi wakakonzerwa nemethylene blue chete. Chechipiri, kupora mushure mechikamu chechiedza hakugoni kungonzi kwakakonzerwa nekushanda kwemakemikari nechiedza pakurwisa tupukanana, nokuti chiedza chitsvuku pachacho chinogona kuchinja kugadziriswa kwematishu. Muchiedzo chemaronda emakonzo chakaitwa naSperandio nevamwe chaiva nemapoka edhayi chete, chiedza chete, zvose zvakasanganiswa, uye boka rekuenzanisa, laser yoga yakakanganisa maitiro ekupora. Kuti mugumisiro unzi wakakonzerwa nekuurayiwa kwemabhakitiriya zvinoda kuongororwa kwetupukanana pamwe nemapoka ekuenzanisa akakodzera. Basa rakaitwa pamhuka rakajeka panyaya iyi: mumuenzaniso wemaronda ane utachiona mumbeva wakaitwa naPérez nevamwe, kurapa kwephotodynamic kwakapa mugumisiro wakanakisisa wekupora unoonekwa nepo mupirocin yakapa kuderera kukuru kwemabhakitiriya, zvichiparadzanisa zviyero zviviri izvi zvakajeka. Ongororo yedu yehumbowo hwemethylene blue nechiedza chitsvuku inoisa nzira idzi dzemaronda pamwe nemashandisirwo echiedza asingabatanidzi maronda kuitira kuti kushanda kumwe chete kwemakemikari nechiedza kusakanganiswe nekufungwa kuti zvinoshandiswa pakurapa chinhu chimwe chete.

Masero nemienzaniso yeganda: panotangira chiratidzo chekupora

Mavambo emurabhoritari echirevo chekupora kwemaronda ari muchidzidzo cha2017 chakaitwa naXiong nevamwe pamasero efibroblast edermis yevanhu neganda rakavakwazve. Masero efibroblast kubva kuvanhu vaviri vakapa masero, akatanga kuiswa 100 nM methylene blue, akazadzazve mukaha wakakwenywa nekukurumidza kwakakura zvakakosha pakuongorora nhamba kupfuura masero asina kuiswa dhayi pamaawa 24. Muganda rakavakwazve rine ukobvu hwakazara, kuramba richiiswa dhayi kwenguva refu kwakawedzera mvura yakayerwa muganda nekukora kwedermis, uye kuwedzera kwekugadzirwa kweelastin neCOL2A1 kwaiva pakati pekuchinja kwechimiro chinotsigira masero.

Izvi zviyero chaizvo zvine chekuita nemaronda, uye zvinofanira kunzwisiswa mukati memienzaniso yazvo. Chiedzo chemukaha wakakwenywa chinoyera kufamba pamwe chete kwemasero achiyambuka mukaha mundiro. Hachina kupindura kwemasimba ekudzivirira muviri, kugara kwemabhakitiriya, mvura inobuda muronda, kana chifukidzo. Ganda rakavakwazve rinowedzera marongerwo ematishu asi richiri kushaya kutenderera kweropa nematanho ose ekupora. Hapana pamuenzaniso miviri iyi unoedza chifukidzo chefuro kana nzira yephotodynamic, uye hapana unopa kusimba kwemusanganiswa wekuisa pamba.

Methylene blue yakagadzirwa mumisanganiswa yakatarwa yakaedzwawo mumaronda emakonzo nembeva. Gel ye0.005% ine niosome yakadzidzwa naFarmoudeh nevamwe yakakurumidzisa kuvharika kwekutanga kwemaronda emakonzo akagadzirwa nekubvisa chikamu chetishu kana ichienzaniswa nedhayi isina kutakurwa muniosome uye zvinhu zvinotakura mushonga zvisina dhayi, iine migumisiro iri nani pakuongororwa kwematishu nezviyero zvekushushikana kunokonzerwa neoxidation. Nanoemulsion ye0.1 mg/mL yakadzidzwa naGao nevamwe mumbeva dzine chirwere cheshuga yakakurumidzisa kuvharika, ichiwedzera zviratidzo zvekugadzirwa kwetsinga itsva dzeropa uye ichideredza zviratidzo zveoxidation nerufu rwemasero rwakarongwa. Magadzirirwo emusanganiswa akakosha muzviitiko zvose zviri zviviri; hapana mugumisiro unobva washandawo kudhayi yakangosanganiswa nemvura.

Uye maitiro emugumisiro haana kufanana nguva dzose. Muchiedzo chekubatanidza ura hwemakonzo chakaitwa naDinc nevamwe, 1% methylene blue yakaiswa mukati medumbu yakaderedza kumanikidzwa kwaidiwa kuti pakabatanidzwa paputike pamwe nehydroxyproline pazuva rechitatu, zvichiratidza kuderera kwesimba rekupora kwekutanga pahuwandu ihwohwo nenzira iyoyo yekuisa. Kusimba kwemusanganiswa, tishu, magadzirirwo emusanganiswa, uye nzira yekuisa ndizvo zvinotara mugumisiro.

Zvekubvunza pachirevo chipi nechipi nezvemaronda

Chirevo chose nezvemethylene blue chine chekuita nemaronda chinofanira kukwanisa kupindura mibvunzo mina. Chekutanga, chii chaizvo chakaiswa: chifukidzo chakagadzirwa chine zita, nzira yakatarwa yechinhu chinonzwa chiedza pamwe nechiedza, kana musanganiswa usina kutsanangurwa? Chechipiri, chakaiswa pachii: masero, ronda remhuka, kana maronda evanhu emhando yakataurwa? Chechitatu, chakaenzaniswa nechii, kwenguva yakareba sei? Chechina, nechiyero chipi chemugumisiro: kuchinja kwenzvimbo, kuvharika, nhamba yemabhakitiriya, kana chiyero chemurabhoritari chinomirira chimwe chinhu?

Zvirevo zvinovhiringidza mubvunzo wekutanga ndizvo zvinowanzokanganisa. Mugumisiro wakawanikwa nefuro rine dhayi hauratidzi kuti kuzora ronda bhuruu kunoshanda zvakafanana, uye chiratidzo chekurwisa tupukanana mushure mechikamu chephotodynamic hachiratidzi kuti kutapura musanganiswa pasina chiedza kunoshanda zvakafanana. Gwara richauya rekuverenga zvirevo zvemethylene blue nezvemaronda richapa rondedzero iyi nzvimbo yayo yechigarire ine mienzaniso yakatsanangurwa; kusvikira ipapo, tafura iri pamusoro ndiyo mepu.

Maronda akadzika, ari kupararira, anonhuwa zvakaipa, ane fivha pamwe nawo, kana asiri kuvandudzika anoda kuongororwa nenyanzvi yezveutano pane dhayi. Tsvakurudzo yaongororwa pano yakakodzera kuteverwa nokuti inonyatsotaura zvinhu zvakashandiswa, mienzaniso, uye zviyero. Chengeta zvinhu zvitatu izvi zvakabatanidzwa nechirevo chose, uye chikamu ichi chetsvakurudzo chinonzwisisika zvakajeka.