封闭负压引流对软组织爆炸创面的影响Effect of vacuum sealing drainage for the soft tissue wound caused by blast injury
薛云;刘兴炎;葛宝丰;陈克明;宋鹏;王勇;樊晓海;李生贵;
摘要(Abstract):
[目的]观察封闭负压引流(vacuum sealing drainage,VSD)对软组织爆炸创面愈合的影响,为战场中所致的爆炸伤初级救治提供新的思路。[方法]用电雷管在8只(50±5)kg的长白猪双侧臀部造成16个爆炸伤创面,配对分为实验组和对照组。实验组创面彻底清创后,VSD治疗3 d,然后打开伤口对创面进行简单的清洗,再用VSD治疗3 d。对照组创面彻底清创后,每日常规换药。[结果]两组创面细菌数在治疗后3、6 d均有显着性差异(P<0.01),实验组细菌数始终没有达到感染临界值105,而对照组3d后的细菌数已达到106;治疗3、6 d后实验组新生肉芽组织中的胶原含量和对照组比较存在显著性差异(P<0.01),实验组高于对照组;并且两组创面中血管内皮生长因子(VEGF)的含量在治疗3、6 d后也出现显著性差异(P<0.01),实验组高于对照组。[结论]爆炸创面早期运用VSD疗法,可抑制细菌增殖,促进肉芽组织形成和伤口愈合。
关键词(KeyWords): 爆炸伤;封闭负压引流;细菌学;胶原;血管内皮生长因子
基金项目(Foundation): 全军“十一五”医学科研项目课题(编号:06G033)
作者(Author): 薛云;刘兴炎;葛宝丰;陈克明;宋鹏;王勇;樊晓海;李生贵;
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