Li Jin-Qing, Chen Shao-Zong, Li Wang-Zhou, Li Yue-Jun, Li Xue-Yong
Department of Burns and Plastics Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, PR China.
Zhonghua Shao Shang Za Zhi. 2008 Feb;24(1):13-7.
To investigate the effect of vacuum-assisted closure (V. A. C.) technology in the treatment of infected wound of skin and soft tissue as a result of explosion injury in pig.
Sixteen explosion wounds were established by electric detonators on the shoulders and hips on both sides of 4 small white domestic pigs ,and they were divided into A group [(without treatment and infection occurred on 1-2 post burn day (PBD), then treated with vaseline gauze on 3 (PBD)], and B group (with the same treatment as in A group, except for treatment of vacuum assisted closure (V. A. C) with pressure of - 15 kPa after 3 PBD). The data of wound depth, wound area, wound healing time were collected and analyzed at 3 PAD and 1, 3, 6, 9, 14, 19, 24 days after treatment. Specimens from wounds were collected for histopathology observation, including also cell proliferation index, the number of vascular endothelial cells, the activity of myeloperoxidase (MPO) and the number of bacteria.
Compared with those in A group on land 3 days after treatment, wound area, wound depth were not enlarged or deepened in B group, while the number of inflammatory cells, vascular endothelial cells, proliferative cells were increased, the activity of MPO was enhanced and the number of bacteria was decreased. There were obvious differences between two groups in following indices: wound area ,wound depth, the number of vascular endothelial cells and bacteria during 1 to 19 days after treatment (P < 0.01)), the number of cell proliferation from 1 - 9 days after treatment (P < 0.01)), and the activity of MPO on 3, 6 days after treatment (P < 0. 01). The wound healing time was (32.8 +/- 1.6) d in A group, which was longer than that in B group (25.8 +/- 1.0 d, P < 0.01).
Compared with conventional dressing change, V. A. C can decrease bacteria load, lessen secondary necrosis, prompt the inflammatory response, accelerate the formation of granulation tissue, shorten wound healing time in infectious wound of porcine skin and soft tissue resulted from explosion injury.
探讨封闭负压引流（V.A.C.）技术对猪爆炸伤所致皮肤软组织感染创面的治疗效果。
采用电雷管在4只小型家猪双侧肩部及臀部制造16处爆炸伤创面，分为A组（伤后1 - 2天未处理，创面感染，伤后3天用凡士林纱布换药）和B组（处理同A组，但伤后3天采用-15 kPa压力的封闭负压引流治疗）。于伤后3天及治疗后1、3、6、9、14、19、24天收集创面深度、创面面积、创面愈合时间等数据并进行分析。取创面标本进行组织病理学观察，包括细胞增殖指数、血管内皮细胞数量、髓过氧化物酶（MPO）活性及细菌数量。
治疗后3天，B组创面面积、创面深度未增大或加深，炎症细胞、血管内皮细胞、增殖细胞数量增多，MPO活性增强，细菌数量减少，与A组相比差异有统计学意义。两组在治疗后1 - 19天的创面面积、创面深度、血管内皮细胞数量及细菌数量（P < 0.01）、治疗后1 - 9天的细胞增殖数量（P < 0.01）、治疗后3、6天的MPO活性（P < 0.01）方面差异均有统计学意义。A组创面愈合时间为（32.8 ± 1.6）天，长于B组（（25.8 ± 1.0）天，P < 0.01）。
与传统换药相比，V.A.C.技术可降低猪爆炸伤所致皮肤软组织感染创面的细菌载量，减少继发性坏死，促进炎症反应，加速肉芽组织形成，缩短创面愈合时间。
