Song Peng, Xue Yun, Ge Bao-feng, Chen Ke-ming, Zhao Dong-hua, Han Gui-qiu, Wang Yong
Institute of Orthopaedics, Lanzhou General Hospital, Lanzhou Command of Chinese PLA, Lanzhou 730050, Gansu, China.
Zhongguo Gu Shang. 2011 Jul;24(7):589-93.
To investigate the effect on early treatment with vacuum-assisted closure(VAC) to wound healing of acute explosion injury in pigs, and provide a new way for early treatment of battle wounds.
Eight healthy 3-month Landrace pigs of both sexes with the body mass of (50 +/- 5) kg were selected in the study. Sixteen battle wounds were made by explosion of same type detonator (pattern number: 660929F48840-55, included DDNP 0.3 g, RDX 0.7 g) in hibateral skin of buttock of 8 pigs, which were divided into experimental group and control group (pair wounds of left and right). The raw sufaces were thorough debrided at 3 h after exposure, according to the characteristics of treatment on the battlefield, experimental group was treated with VAC under the pressure of (-50 +/- 5) Kpa after debridement and sterilization and control group was treated with routine dry sterile gauze draping. Results of bacteriology (bacterial counts and the proportion of G+ bacteria) and pathology (HE stain and Masson stain) were detected at every wound before and after treatment.
At the 3 days after treatment,the bacterial number in the experimental group was [(7.82 +/- 0.55) x 10(4) ] CFU/g, in control group was [(1.07 +/- 0.14) x 10(6)] CFU/g. There was significant difference between two groups. The proportion of G+ bacteria in experimental group was significantly increased. The raw surface in experimental group was clean with affluent and neoformative granulation tissue, blood vessels and collagen, necrotic tissue decreased obviously by pathological observation.
VAC could reduce the quantity of bacteria, improve the proportion of G+ bacteria, and promote the formation of granulation tissue and the healing of wound. The VAC for the treatment of battle wounds has a positive effect.
探讨早期应用封闭负压引流（VAC）技术对猪急性爆炸伤创面愈合的影响，为战伤早期救治提供新途径。
选取8头健康3月龄、体质量（50±5）kg的长白猪，雌雄不限。用同一型号雷管（型号：660929F48840 - 55，含叠氮铅0.3 g、黑索今0.7 g）在8头猪双侧臀部皮肤制造16处战伤，分为实验组和对照组（左右侧创面配对）。伤后3 h按战场救治特点对创面进行彻底清创，实验组清创消毒后采用VAC技术，压力为（-50±5）kPa，对照组采用常规干燥无菌纱布覆盖。治疗前后分别对每个创面进行细菌学（细菌计数及革兰阳性菌比例）和病理学（苏木精-伊红染色及Masson染色）检测。
治疗后3 d，实验组创面细菌数为[（7.82±0.55）×10⁴]CFU/g，对照组为[（1.07±0.14）×10⁶]CFU/g，两组差异有统计学意义。实验组革兰阳性菌比例明显升高。病理观察显示，实验组创面清洁，有丰富的新生肉芽组织、血管及胶原，坏死组织明显减少。
VAC技术能减少创面细菌数量，提高革兰阳性菌比例，促进肉芽组织形成和创面愈合，对战伤治疗有积极作用。
