硅橡胶封闭式负压引流系统对猪急性皮肤损伤的疗效观察  

Observation on the effect of a silicone rubber vacuum sealing drainage system in the treatment of acute skin defect in pigs

作　　者：翟延荣[1] 朱亚萍[1] 张秀珍[1] 张雨凡 钟晓娟 鲁香月 赵嵌嵌 邹俊[2] Zhai Yanrong;Zhu Yaping;Zhang Xiuzhen;Zhang Yufan;Zhong Xiaojuan;Lu Xiangyue;Zhao Qianqian;Zou Jun(Department of Wound Repair,People′s Hospital of Wuzhong,Suzhou 215128,China;Department of Orthopedic Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州市吴中人民医院创面修复科,215128 [2]苏州大学附属第一医院骨科,215006

出　　处：《中华损伤与修复杂志(电子版)》2025年第2期148-154,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：江苏省苏州市科技计划项目(SKY2022033);江苏省苏州市吴中区科技计划项目。

摘　　要：目的比较硅橡胶封闭式负压引流系统与传统聚氨酯负压封闭引流系统治疗猪急性皮肤损伤的疗效。方法选择5只实验用巴马小型猪,建立猪急性皮肤损伤模型。在猪背部制造4个急性皮肤损伤创面,创面1、创面3为长7 cm深达肌层的长切口并缝合(缝合伤创面),创面2、创面4为4 cm×4 cm全层皮肤缺损创面(切割伤创面)。同一实验动物创面1、创面2使用硅橡胶封闭式负压引流系统治疗(实验组),创面3、创面4使用聚氨酯负压封闭引流系统治疗(对照组)。每5天更换1次敷料。于治疗第10天观察创面愈合情况,测量创面面积和创面体积,取创面肉芽组织行HE染色、Masson染色及CD31免疫组化染色,比较2组创面愈合率、创面与敷料黏连和出血情况,以及血管新生和胶原形成情况。结果缝合伤创面在治疗第5天表皮已愈合,治疗第10天HE染色及Masson染色提示实验组创面两侧胶原纤维连接较对照组更明显。切割伤创面治疗第10天,2组均可见创面缩小,2组创面面积缩小率差异无统计学意义(41.13%±12.15%比34.14%±8.24%,t=-1.225,P=0.288),但实验组创面体积缩小更明显(72.47%±8.25%比51.12%±9.39%,t=5.061,P=0.007);CD31免疫组化染色及Masson染色提示2组创面均可见毛细血管增生及胶原形成,实验组CD31平均光密度值(1.00±0.05比0.57±0.04,t=-19.806,P<0.001)及Masson染色胶原容积分数(40.53%±10.71%比24.94%±7.68%,t=-3.154,P=0.034)均高于对照组。切割伤创面治疗第5天,更换敷料时2组均无创面与敷料黏连情况;治疗第10天,揭除敷料时实验组未发生创面与敷料黏连情况,对照组创面与敷料发生明显黏连,且伴有创面出血(P<0.05)。结论硅橡胶封闭式负压引流系统应用于猪急性全层皮肤缺损,可加快创面血管化及胶原形成,促进创面愈合,且减少更换敷料时创面与敷料黏连。Objective To compare the effect of silicone rubber vacuum sealing drainage system and traditional polyurethane vacuum sealing drainage system in treating acute skin defect in pigs.Methods Five Bama miniature pigs were selected to establish an acute skin injury model in pigs.Four wounds were constructed on the backs of the experimental Bama miniature pigs.The No.1 and No.3 wounds were sutured injury with a length of 7 cm and the deep from epidermis to the muscle layer(sutured wounds),while the NO.2 and NO.4 wounds were cutting injury with 4 cm×4 cm full-thickness skin defect(incised wounds).The NO.1 and NO.2 wounds were treated with silicone rubber vacuum sealing drainage system(experimental group),while the NO.3 and NO.4 wounds were treated with polyurethane vacuum sealing drainage system(control group).The dressings were changed every 5 days.On day 10 of the treatment,wound healing was assessed by measuring wound area and volume,the wounds were measured to compare the wound healing rate,adhesion and bleeding between the wound and dressing,and the angiogenesis and collagen formation were observed by hematoxylin-eosin staining,Masson staining,and CD31 immunohistochemical staining.Results The epidermis of suture injury wounds had healed on day 5 of the treatment both in experimental group and control group,but the results of hematoxylin-eosin staining and Masson staining showed that more collagen fiber connections between the two sides of the wounds was observed in experimental group.On day 10 of the treatment,the wound areas of cutting injury in both groups decreased,there was no significant difference between the two groups(41.13%±12.15%vs 34.14%±8.24%,t=-1.225,P=0.288),while the wound volume reduction rate in experimental group was significantly higher than that in control group(72.47%±8.25%vs 51.12%±9.39%,t=5.061,P=0.007).Capillary hyperplasia and collagen formation were both observed by CD31 immunohistochemical staining and Masson staining in the two groups,while the average optical density value of CD31(

关 键 词：负压伤口疗法 巴马小型猪 全层皮肤缺损 硅橡胶 聚氨酯 

分 类 号：R47[医药卫生—护理学]