| Chronic wounds(also called Chronic ulcers)could be caused directly by trauma or burn and other Accidental injury. In recent years they occur in a series of complications caused by the metabolic disease or age-related diseases, like Diabetic ulcers, pressure ulcers caused by Bedridden, ulcers led by Lower limb circulatory disorders, the treatment has been the important medical burden of Modern industrialized and aged society.The question why the wounds are_refractory has been raised for a long time. Etiology, pathogenesis and prevention and other aspects of its mechanism has been under research, many hypothesis have been raised:Ischemia and hypoxia、 edema, Increased capillary permeability caused by Blood circulation disorders, glycosylation products on Diabetic ulcers cause damage to the repair cell slow down the repairement of wounds.For a long time, wound infection has been one of the key factors that affect wound healing, control of wound infection is important for the preparation before the surgery; long-term wound infection, especially, has been the key factors plagued clinical repairment. Humoral’hydrogen ions (H+) is essential for the health regulation, the rate of chemical reaction can be changed even a tiny variation in ion concentration. PH value in the wound microenvironment can affect many aspects, including the release of oxygen, angiogenesis, enzyme activity, bacterial virulence. Study showed that the PH value change can significantly inhibit the growth of bacteria in the wound microenvironment, but there is no relevant reports on the change of PH degree and the degree of inhibition of bacterial growth and also a lack of clinical research on the change of PH value of the wound microenvironment to wound healing. Objective:①To investigate the distribution of bacterial flora in the wound infection and provide the basis and guidance for the clinical use of antibiotics.②To explore the impact of bacterial growth under different pH values.③To explore the relationship between the variations of PH value in microenvironment and wound healing.Methods:①Adopt Retrospective survey to summarize the medical records of patients with wound infection in our department from January2009to June2011②Apply plate colony counts to statistic the correspondence between the different OD values and bacterial number③Adopt turbidimetric method to detect Absorbance of bacteria under different pH values.④Select25cases of chronic wound patients, divided into experimental and control groups by random number table method, the experimental group apply intervention on the dressing PH value, observe the growth of granulation of wound and treatment timeResults:1、245cases of chronic wounds secretion after the bacteria cultures on patients, including positive results for221times, negative results24times, positive rate was90.2%.221times positive results include17kinds of bacter, escherichia coli (31/221), staphylococcus aureus (45/221),pseudomonas aeruginosa (54/221) total respectively14.0%, and24.4%, staphylococcus aureus contains resistance to dermatologists (MRSA)28cases, accounting for62%of staphylococcus aureus.2、 In small environment different PH value bacteriostatic effect not completely the same, PH value in the acidic environment (PH=5), antibacterial effect is best, along with the increase of the PH value, the inhibition the growth of the bacteria function abate, PH=7, the most suitable for bacteria growth, alkaline environment on bacteria growth inhibition, but compared with the acidic environment (PH=5), restrain the growth of the bacteria ability is weak, the difference was significant (P<0.05).3、 Acidic dressing change medicine and conventional dressing change medicine on the prevention and treatment of local wound infection the clinical curative effect of the significant difference.(P<0.05)Conclusion:1. The dominant bacteria in the plastic surgery ward of the First Affiliated Hospital of Zhengzhou University are Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli in the past three years.2. The inhibitory effect of different pH values in microenvironment are not identical, the antibacterial effect are the best when the PH value is under the acidic environment (PH=5), with the increase of PH value, the inhibition of bacterial growth weakened, the most suitable PH value for bacterial growth is7, alkaline environment inhibit bacterial growth, compared with the acidic environment (pH=5), the ability to inhibit bacterial growth is weaker, the differences were significantly.3. Slightly acidic environment in local wound can effectively prevent local wound infection and promote wound healing (P<0.05). |
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