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

作　　者：薛云[1] 刘兴炎[2] 葛宝丰[2] 陈克明[2] 宋鹏[2] 王勇[2] 樊晓海[2] 李生贵[2] 

机构地区：[1]第四军医大学西京医院,西安710032 [2]兰州军区兰州总医院全军骨科中心,兰州730050

出　　处：《中国矫形外科杂志》2011年第6期495-498,共4页Orthopedic Journal of China

基　　金：全军"十一五"医学科研项目课题(编号:06G033)

摘　　要：[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。[Objective]To investigate the efficacy of vacuum sealing drainage（VSD） for wound healing of acute explosion wounds in pigs,and to provide a new therapy for early treatment of blast wounds. [Method]Sixteen blast wounds,created by explosion of a specific type of electric detonations which were fixed at 1cm over the skin of the hips of six healthy adult Landrace pigs（45-55kg）,were divided into VSD group and control group.VSD group was treated with VSD 3 days after debridement and sterilization,and repeated the delridement and VSD 3days.Control group was treated with routine redressing. [Result]The difference of wound bacteria loads between VSD group and control group was statistically significant at 3and 6 days.Bacteria loads in VSD group were not increased to 105CFU/g in 6 days,and in group A were increased to 106 CFU /g.As compared with the control group collagen in granulation tissue was rich in VSD group.The difference of wound VEGF between VSD group and control group was statistically significant at 3 and 6 days. [Conclusion]VSD could reduce the loading of bacteria,promote the formation of granulation tissue and the healing of wound.

关 键 词：爆炸伤 封闭负压引流 细菌学 胶原 血管内皮生长因子 

分 类 号：R82[医药卫生—临床医学]