Chen X J, Liu S, Gao G Z, Yan D X, Jiang W S
Department of Burn and Plastic Surgery, the 253rd Hospital of People's Liberation Army, Xincheng District, Hohhot, Inner Mongolia, China.
Braz J Med Biol Res. 2017 Oct 2;50(12):e5837. doi: 10.1590/1414-431X20175837.
This study was designed to assess the efficacy of vacuum sealing drainage (VSD) on skull exposure wounds in rabbits and to investigate the underlying mechanism of the process. Full-thickness excisional circular wounds 2×2 cm with or without periosteum involvement were created in 88 New Zealand white rabbits (mean body weight: 3.0±0.65 kg). Animals were randomly divided into 4 groups: periosteum-intact wounds treated with traditional dressing (p+control), periosteum-intact wounds treated with VSD (p+VSD), periosteum-lacking wounds treated with traditional dressing (p-control) and periosteum-lacking wounds treated with VSD (p-VSD). The wounds treated with traditional dressing were covered with Vaseline gauze, while VSD treatment was accompanied with continuous -120 mmHg pressure. Finally, wound tissues were harvested for analysis of hydroxyproline content and histologic detection. VSD hastened the wound healing process significantly (P<0.05) compared to the corresponding control groups. VSD alleviated the inflammation reaction, accelerated re-epithelialization and facilitated the organization of collagen fibers into neat rows. During the wound healing process, the hydroxyproline content increased overtime [i.e., postoperative days (POD) 7, POD 10 and POD 15] in all four groups, and it peaked in the p+VSD group. VSD also promoted angiogenesis via increasing number and quality of collagen. We concluded that VSD can promote healing in bone-exposed wounds via increasing hydroxyproline content and vessel density, reducing inflammatory responses and generating ordered collagen arrangement.
本研究旨在评估负压封闭引流(VSD)对兔颅骨外露伤口的疗效,并探讨其潜在机制。在88只新西兰白兔(平均体重:3.0±0.65 kg)身上制作直径2×2 cm的全层圆形切除伤口,伤口有无骨膜受累。动物被随机分为4组:用传统敷料治疗的有骨膜伤口(p+对照组)、用VSD治疗的有骨膜伤口(p+VSD组)、用传统敷料治疗的无骨膜伤口(p-对照组)和用VSD治疗的无骨膜伤口(p-VSD组)。用传统敷料治疗的伤口用凡士林纱布覆盖,而VSD治疗则伴有持续-120 mmHg的压力。最后,采集伤口组织分析羟脯氨酸含量并进行组织学检测。与相应的对照组相比,VSD显著加速了伤口愈合过程(P<0.05)。VSD减轻了炎症反应,加速了上皮再形成,并促进了胶原纤维排列成整齐的束状。在伤口愈合过程中,所有四组的羟脯氨酸含量均随时间增加[即术后第7天(POD 7)、第10天(POD 10)和第15天(POD 15)],且在p+VSD组达到峰值。VSD还通过增加胶原的数量和质量促进血管生成。我们得出结论,VSD可通过增加羟脯氨酸含量和血管密度、减少炎症反应以及形成有序的胶原排列来促进骨外露伤口的愈合。