Li Hongfei, Pan Zhaohui, Xue Shan, Zhao Yuxiang
Department of Orthopedic Diseases, the 89th Hospital of Chinese PLA, Weifang Shandong, 261021, P.R.China.
Department of Orthopedic Diseases, the 89th Hospital of Chinese PLA, Weifang Shandong, 261021,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jan 15;32(1):45-50. doi: 10.7507/1002-1892.201707023.
To investigate the feasibility of Drawtex hydroconductive dressing in treatment of early implantation-associated infection and soft tissue defect after internal fixation of tibial fracture.
Thirty-six New Zealand rabbits were used to prepare the model of early implantation-associated infection after internal fixation of tibial fracture, and randomly divided into 3 groups ( =12) . The infected wounds were covered with Drawtex hydroconductive dressing (group A), chitosan solution gauze (group B), and normal saline gauze (group C), respectively. The dressing was changed every 2 days. X-ray films were performed at 1, 14, and 21 days. The gross observation, microbiological evaluation, and histological observation were done at 21 days.
There was no significant difference in the wound grading according to the James' grading criteria between groups at 21 days ( =3.713, =0.156). X-ray films showed no bone destruction in all groups at 1 day; and there was no significant difference in radiographic scores between groups ( >0.05). At 14 days, the mild osteolysis was observed in group B; the radiographic score was significantly lower in groups A and C than in group B ( <0.05), but there was no significant difference between groups A and C ( >0.05). At 21 days, the osteolysis and osteomyelitis were observed in groups B and C; the radiographic score was significantly lower in group A than in groups B and C ( <0.05), but there was no significant difference between groups B and C ( >0.05). Also, the microorganism in bone tissue of group A was less than that of groups B and C ( <0.05); and the difference between group B and group C was not significant ( >0.05). Histological observation showed the mild inflammatory cell infiltration in group A and many inflammatory cells in groups B and C. The Smeltzer histological score was significant lower in group A than in groups B and C ( <0.05); and there was no significant difference between groups B and C ( >0.05).
Drawtex hydroconductive dressing can be used for the implantation-associated infection after tibial fracture internal fixation. And the effectiveness of Drawtex hydroconductive dressing is better than that of chitosan solution gauze and normal saline gauze.
探讨Drawtex水导电敷料治疗胫骨骨折内固定术后早期植入相关感染及软组织缺损的可行性。
选用36只新西兰兔制备胫骨骨折内固定术后早期植入相关感染模型，并随机分为3组（每组12只）。分别用Drawtex水导电敷料（A组）、壳聚糖溶液纱布（B组）和生理盐水纱布（C组）覆盖感染伤口。每2天更换敷料。分别在1、14和21天拍摄X线片。在21天进行大体观察、微生物学评估和组织学观察。
21天时，根据詹姆斯分级标准，各组伤口分级差异无统计学意义（F=3.713，P=0.156）。X线片显示1天时所有组均无骨质破坏；各组影像学评分差异无统计学意义（P>0.05）。14天时，B组观察到轻度骨质溶解；A组和C组的影像学评分显著低于B组（P<0.05），但A组和C组之间差异无统计学意义（P>0.05）。21天时，B组和C组观察到骨质溶解和骨髓炎；A组的影像学评分显著低于B组和C组（P<0.05），但B组和C组之间差异无统计学意义（P>0.05）。此外，A组骨组织中的微生物少于B组和C组（P<0.05）；B组和C组之间差异无统计学意义（P>0.05）。组织学观察显示A组有轻度炎性细胞浸润，B组和C组有大量炎性细胞。A组的斯梅尔策组织学评分显著低于B组和C组（P<0.05）；B组和C组之间差异无统计学意义（P>0.05）。
Drawtex水导电敷料可用于胫骨骨折内固定术后植入相关感染。且Drawtex水导电敷料的效果优于壳聚糖溶液纱布和生理盐水纱布。
