Department of Plastic and Burn Surgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China.
J Trauma Acute Care Surg. 2012 Oct;73(4):908-13. doi: 10.1097/TA.0b013e318253b592.
War injuries, especially blast injuries, have a high risk of infection. However, no animal models of infected war injuries have been built in large animals, which retards both the understanding and the treatment optimization of infected war injuries.
Soft tissue blast injuries were created by explosion of electric detonators in white domestic pigs. The ultra structure of the tissue around the wound was determined by transmission electron microscope. To develop infection of blast injury wounds, the pigs were housed in a standard animal house which was disinfected periodically, and the wounds were left untreated for 3 days. Wound specimens were collected daily to determine the bacterial load and bacterial components. To determine whether infection induces tissue necrosis in infected soft tissue blast injury wounds, uninfected blast injury wounds were created as controls of infected wounds by surgical debridement daily, and the wound area and wound depth of both wounds were measured.
The wound area and the wound depth of the soft tissue blast injury created in this study fell in the range of human moderate soft tissue war injuries, and the ultra structure of the wounds was comparable with that of human blast injury wounds. The bacterial load of uninfected wounds was under 10 colony forming unit/g during the first 3 days of injury, while that of infected wounds was over 10 colony forming unit/g after 2 days of injury. The infected soft tissue blast injury wounds contained most of the bacteria frequently isolated in battlefield wounds. In addition, infection induced evident tissue necrosis in infected blast injury wounds.
The infected soft tissue blast injury wounds mimic those in human, and they can be used to address key points of treatment optimization.
战争创伤，尤其是爆炸伤，具有很高的感染风险。然而，大型动物中尚未建立感染性战争创伤的动物模型，这阻碍了对感染性战争创伤的理解和治疗优化。
通过电雷管爆炸在白色家猪中创建软组织爆炸伤。通过透射电子显微镜确定伤口周围组织的超微结构。为了使爆炸伤伤口感染，将猪饲养在标准动物房中，定期对动物房进行消毒，并且使伤口未经过处理 3 天。每天采集伤口标本以确定细菌负荷和细菌成分。为了确定感染是否会引起感染性软组织爆炸伤伤口的组织坏死，通过每天手术清创术创建未感染的爆炸伤伤口作为感染伤口的对照，并测量两个伤口的伤口面积和伤口深度。
本研究中创建的软组织爆炸伤的伤口面积和伤口深度处于人类中度软组织战伤的范围内，并且伤口的超微结构与人类爆炸伤伤口相似。未感染伤口的细菌负荷在受伤后 3 天内低于 10 个菌落形成单位/g，而感染伤口在受伤后 2 天内超过 10 个菌落形成单位/g。感染的软组织爆炸伤伤口包含了在战场上伤口中经常分离到的大多数细菌。此外，感染会引起感染性爆炸伤伤口明显的组织坏死。
感染的软组织爆炸伤伤口模拟了人类的伤口，可以用于解决治疗优化的关键点。
