封闭负压引流技术对猪肢体枪伤感染和愈合时间的影响

目的观察封闭负压引流技术(Vacuum sealing drainage,VSD)对清创后肢体枪伤感染和愈合的影响。方法 20头猪枪击致伤右后肢,6h内彻底清创,随机分为对照组(常规处理)和实验组(VSD治疗),每组10头。比较两组伤道细菌计数、病理形态学及延期缝合时间和愈合时间。结果两组的细菌计数在清创后24、48、72h实验组低于对照组差异有统计学意义(P<0.05)。对照组有3个肢体感染,实验组和对照组延期缝合时间分别为(4.1±0.7)d、(8.2±3.6)d,愈合时间分别为(15.1±1.5)d、(22.2±3.4)d,差异均有统计学意义(P<0.01)。统计分析时不包括3个感染肢体,两组差异也有统计学意义(P<0.01)。病理显示实验组组织炎症反应明显减轻、组织修复加快。结论 VSD可以预防清创后枪伤发生感染,促进枪伤愈合。

Effect of vacuum sealing drainage on infection and healing time of gunshot wounds on swine extremities

Objective To assess the effect of vacuum sealing drainage ( VSD) on infection and wound healing of gunshot wounds on swine extremity after debridement.Methods Twenty swine were shot and injured on right hind and were debrided in 6 hours.Then they were randomly divided into control group and trial group ( n=10/group) .The control group was treated with conventional therapy,and the trial group was treated with VAC.Bacteria count,pathological morphology,delayed suture time and healing time were compared between the two groups.Results The bacteria count in the trial group was lower at the time of 24-,48-,and 72-h after debridement than that in the control group ( P<0.05) .There were three extremities infec-ted in the control group.The delayed suture time of the trial group and the control group were ( 4.1±0.7) and ( 8.2±3.6) days,and the healing time were ( 15.1±1.5) and( 22.2±3.4) days,respectively.There were significant differences between the two groups ( P<0.01) .Statistical analysis was done except three extremities infected,and the difference was also significant ( P<0.01) .The outcomes of pathology showed that inflammatory response reduced,and tissue repair accelerated in the trial group.Conclusion VSD can prevent gunshot wounds from being infected after debridement,and promote wound healing.