Hu Chao, Zhang Taogen, Ren Bin, Deng Zhouming, Cai Lin, Lei Jun, Ping Ansong
Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China (mainland).
Department of Orthopedics, People' Hospital of Daye City, Daye, Hubei, China (mainland).
Med Sci Monit. 2015 Apr 27;21:1200-6. doi: 10.12659/MSM.892939.
Patients with composite bone non-union and soft tissue defects are difficult to treat. Vacuum-assisted closure (VAC) combined with open bone grafting is one of the most effective treatments at present. The aim of the present study was to preliminarily investigate the effect and mechanism of VAC combined with open bone grafting to promote rabbit bone graft vascularization, and to propose a theoretical basis for clinical work.
MATERIAL/METHODS: Twenty-four New Zealand white rabbits were randomly divided into an experimental and a control group. Allogeneic bones were grafted and banded with the proximal femur with a suture. The experimental group had VAC whereas the control group had normal wound closure. The bone vascularization rate was compared based on X-ray imaging, fluorescent bone labeling (labeled tetracycline hydrochloride and calcein), calcium content in the callus, and expression of fibroblast growth factor-2 (FGF-2) in bone allografts by Western blot analysis at the 4th, 8th, and 12th week after surgery.
At the 4th, 8th, and 12th week after surgery, the results of the tests demonstrated that the callus was larger, contained more calcium (p<0.05), and expressed FGF-2 at higher levels (p<0.05) in the experimental group than in the control group. Fluorescent bone labeling showed the distance between the two fluorescent ribbons was significantly shorter in the control group than in the experimental group at the 8th and 12th week after surgery.
VAC combined with open bone grafting promoted rabbit bone graft vascularization.
合并骨不连和软组织缺损的患者治疗困难。负压封闭引流(VAC)联合开放植骨是目前最有效的治疗方法之一。本研究旨在初步探讨VAC联合开放植骨促进兔骨移植血管化的效果及机制,为临床工作提供理论依据。
材料/方法:将24只新西兰白兔随机分为实验组和对照组。将同种异体骨移植至股骨近端并用缝线绑扎。实验组采用VAC,对照组采用常规伤口闭合。术后第4、8和12周,通过X线成像、荧光骨标记(盐酸四环素和钙黄绿素标记)、骨痂中的钙含量以及Western blot分析异体骨中碱性成纤维细胞生长因子-2(FGF-2)的表达来比较骨血管化率。
术后第4、8和12周,检测结果表明,实验组的骨痂更大,钙含量更高(p<0.05),FGF-2表达水平更高(p<0.05)。荧光骨标记显示,术后第8和12周,对照组两条荧光带之间的距离明显短于实验组。
VAC联合开放植骨促进了兔骨移植血管化。