大网膜游离移植在犬肢体爆炸伤合并海水浸泡后的应用研究  

The application of omentum free grafting in the treatment of explosive wounds with seawater immersion in the dog limb

作　　者：张旭东[1] 赵启明[1] 王文慧[1] 陆新[1] 夏东胜[1] 陆海山[1] 叶丽丽[1] 

机构地区：[1]解放军第一一七医院整形外科中心,杭州310013

出　　处：《中华航海医学与高气压医学杂志》2015年第4期262-266,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的 通过犬后肢爆炸伤合并海水浸泡伤模型,探讨大网膜游离移植在肢体爆炸伤合并海水浸泡后的应用价值.方法 32只杂种犬按体质量作为配对因素,用区组随机排列的方式分为大网膜游离移植组（大网膜组）和腹直肌肌皮瓣游离移植组（肌皮瓣组）,每组16只.每只犬的左后肢炸伤后,立即浸入含副溶血弧菌（1.0×106 cfu/ml）的海水中1h.3d后分别行大网膜游离移植或腹直肌肌皮瓣游离移植修复创面.观察2组术后全身反应、局部感染情况、骨折愈合情况和病理学检查结果等,比较2组的修复能力.结果 大网膜组14只、肌皮瓣组15只组织瓣存活,2组存活率差异无统计学意义（P＞0.05）;全身反应的严重程度、局部感染发生率和局部中性分叶核浸润情况等方面,大网膜组均低于肌皮瓣组,说明大网膜游离移植后局部抗感染能力较强;大网膜组4个月时骨折愈合率为73.3％,明显高于肌皮瓣组的42.9％.结论 在特定的环境下应用大网膜游离移植修复肢体爆炸伤合并海水浸泡伤来说,可以获得较好的效果.Objective To investigate the application of omentum free grafting in the treatment of explosive wounds with seawater immersion in the dog limb,through an animal model of explosive wounds coupled with seawater immersion.Methods In accordance with their body mass,32 mongrel dogs were divided into 2 groups,the omentum free grafting group （or simply the omentum group） and the abdominal muscle free grafting group （or simply the muscle group）,each consisting of 16 animals.The left hinder limbs of the dogs were immersed in the artificial seawater with parahaemolyticus （1.0 × 106 cfu/ml） for one hour following blasting.Three days later,omentum free grafting and abdominal muscle free grafting were performed to repair the wound surface.Then,systemic reaction,local infection,bone fracture healing and pathological detection were closely observed,and the repair capacity was compared between the 2 groups.Results The tissue flaps in the 14 animals of the omentum group and 15 animals of the muscle group survived,however no statistical significance could be noted,when comparisons were made in the survival rates of the two groups （P 〉 0.05）.From the seriousness of systemic reaction,rate of local infection and local lobulated infiltration,the levels of the omentum group were all lower than those of the muscle group,indicating that the capacity of local anti-infection of the omentum group was greater following omentum free grafting.The healing rate of bone fracture for the omentum group at month 4 was 73.3%,which was significantly higher than that of the muscle flap group （42.9%）.Conclusions In the treatment of explosive wounds coupled with seawater immersion,the application of omentum free grafting could achieve satisfactory results,under certain specific conditions.

关 键 词：移植 爆炸伤 海水浸泡 大网膜 

分 类 号：R82[医药卫生—临床医学]