便携式负压引流装置促进创面愈合的实验研究
Portable vacuum assisted closure device promotes wound healing
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摘要: 目的 评估有发明专利的自制便携式负压引流装置(专利号:ZL200920168550.9)对爆炸创面的引流效果,为开发战伤早期救治装备提供新思路。方法 选取健康长白猪8头,体质量50kg左右,用电雷管紧贴双侧臀部皮肤,造成16个损伤程度相当的爆炸创面,左右创面配对分成实验组和对照组。在室外暴露3h后进行清创,实验组用封闭负压引流处理,负压值维持在-(50±5)kPa;对照组用无菌干纱布覆盖。分别于清创前、清创后和3d后进行大体观察、细菌学计数、羟脯氨酸含量测定和采集病理学标本进行HE染色。结果 治疗3d后实验组创面细菌数为(7.82±0.55)×103 CFU/g,对照组为(1.07±0.14)×106 CFU/g,两组间具有极显著差异(P<0.01)。实验组羟脯氨酸含量(82.13±2.14)mg/g,对照组(39.76±4.37)mg/g,两组间有极显著性差异(P<0.01)。实验组创面清洁,较对照组有更丰富的新生肉芽组织、毛细血管管腔和成纤维母细胞,坏死组织明显减少。结论 该便携式负压引流装置在本实验中爆炸伤愈合方面效果显著,且操作简单,携带方便,可进一步临床验证。Abstract: Objective To assess the drainage of blast wounds with a portable vacuum drainage device made in China(patent number: ZL200920168550.9) in order to provide a new idea for the development of equipments used in early treatment of war wounds. Methods Sixteen blast wounds induced by explosion of a specific type of electric detonations fixed on hips of 8 healthy adult Landrace pigs were divided into experimental group and control group.According to the characteristics of treatment on the battlefield,blast wounds in experimental group were treated with VAC under the pressure of-(50±5)kPa after debridement and sterilization and those in control group were treated with routine redressing.Bacteriology,hydroxyproline and pathology(HE staining) were detected at each time point. Results The bacteria loads were(7.82±0.55)×103 CFU /g in experimental group and increased to(1.07±0.14)×106 CFU/g in control group(P<0.05),while the hydroxyproline was(82.13±2.14)mg/g in experimental group and(39.76±4.37)mg/g in control group(P<0.05) 3 days after treatment.Pathological examination showed that the wounds were cleaner and the necrotic tissue was less in experimental group with a wealth of new granulation tissue and blood vessels than those in control group 3 days after treatment. Conclusion Portable vacuum drainage device can effectively drain blast wounds and is easy to operate.Further clinical validation is needed.
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