[封闭式负压引流促进实验猪爆震伤腹部创面愈合]

[Vacuum sealing drainage promotes experimental pig explosive abdomen wound healing].

作者信息

Shi Junli, Xi Wenjin, Yi Chenggang, Wang Zhijun, Guo Shuzhong, Han Yan

机构信息

PLA Institute of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.

Department of Immunology, School of Basic Medicine, Fourth Military Medical University, Xi'an 710032, China.

出版信息

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2014 Mar;30(3):312-5.

PMID:24606754

Abstract

OBJECTIVE

To explore the roles of vacuum sealing drainage (VSD) in controlling infection and promoting healing on the experimental pigs with blast injury in the abdomen and exposed internal organs.

METHODS

All animals with full-thickness abdominal wall defect were randomly divided into experimental group (VSD group) and control group (saline gauze group). Debridement was performed 6 hours after wounding. VSD devices (-125 mmHg) were imbedded on animals in the experimental group, while in the control group gauzes with saline solution were used to cover the wound and conventional treatment of dressing change was done. Specimens of muscle tissue in the wound were collected respectively from the two groups to make bacteria quantification 6 hours before the treatment and on the 1st, 3rd, 5th, and 7th day of treatment. Specimens of abdominal drainage fluid were collected respectively on the 1st, 3rd, 5th, and 7th day of treatment to detect inflammatory cytokines (TNF-α, IL-1, IL-6) using ELISA kit. Specimens of the skin and muscle tissues were collected respectively from the two groups on the 7th day to detect target genes (VEGF, bFGF, EGF, and MMP-9) using qRT-PCR.

RESULTS

The bacteria counts (CFU/g) in the VSD group on the 1st, 3rd, 5th, and 7th day of treatment were significantly less than those in the control group at the corresponding time points, and the differences between the two groups were statistically significant (P<0.01). There were no distinct differences between the two groups in the expressions of TNF-α, IL-1 and IL-6 in the abdominal drainage fluid of pig on the 1st day of treatment. The expressions of TNF-α, IL-1 and IL-6 on the 3rd, 5th, and 7th day of treatment in the VSD group were significantly lower than those in the control group at the corresponding time points (P<0.01). The expressions of VEGF, EGF and bFGF in the skin and soft tissues in the VSD group on the 7th day was higher than those in the control group (P<0.01), while the expression of MMP-9 showed no statistical significant difference between the two groups (P>0.05).

CONCLUSION

VSD can effectively control the amount of bacteria in the wound, and reduce the expressions of pro-inflammatory factors such as TNF-α, IL-1 and IL-6 in drainage fluid. VSD also promotes the expressions of growth factors in the wound.

摘要

目的

探讨封闭式负压引流（VSD）技术在腹部爆炸伤合并内脏外露实验猪控制感染和促进愈合中的作用。

方法

将所有腹壁全层缺损动物随机分为实验组（VSD组）和对照组（生理盐水纱布组）。伤后6小时进行清创。实验组动物植入VSD装置（-125 mmHg），对照组用含生理盐水的纱布覆盖伤口并进行常规换药处理。分别于治疗前6小时及治疗第1、3、5、7天采集两组伤口肌肉组织标本进行细菌定量。于治疗第1、3、5、7天分别采集腹腔引流液标本，采用ELISA试剂盒检测炎性细胞因子（TNF-α、IL-1、IL-6）。于治疗第7天分别采集两组皮肤及肌肉组织标本，采用qRT-PCR检测目的基因（VEGF、bFGF、EGF、MMP-9）。

结果

治疗第1、3、5、7天，VSD组伤口细菌计数（CFU/g）明显低于同期对照组，两组比较差异有统计学意义（P<0.01）。治疗第1天，两组猪腹腔引流液中TNF-α、IL-1及IL-6表达差异无统计学意义。治疗第3、5、7天，VSD组TNF-α、IL-1及IL-6表达明显低于同期对照组（P<0.01）。治疗第7天，VSD组皮肤及软组织中VEGF、EGF及bFGF表达高于对照组（P<0.01），而MMP-9表达两组比较差异无统计学意义（P>0.05）。