岛状肌瓣对四肢Ⅲb骨折抗感染能力的评估

Evaluation of antibacterial capability of the island muscular flap on type Ⅲb fracture of limb

目的 :利用岛状肌瓣的动物模型 ,探讨游离肌瓣在四肢骨折修复中的抗感染能力。 方法 :切除家兔的股四头肌及其下前半侧骨膜 ,暴露股骨干 ,用电踞切下 1 .5cm× 0 .4cm大小的密质骨 ,将其浸泡在 0 .2ml含有 5× 1 0 5个细菌的盐水溶液中 ,30min后骨块回植原位。以腹壁下动脉为蒂的腹直肌肌瓣和以腹壁浅动脉为蒂的下腹部皮瓣 ,转位修复兔大腿创面。 结果 :术后岛状肌瓣修复组血白细胞升高水平和持续时间小于皮瓣修复组 ,1个月后局部骨块感染率和细菌计数也低于皮瓣组。 结论 :岛状肌瓣在四肢骨外露和感染创面的修复中具有很强的抗感染能力 。

Objective:An experienmental model was designed to evaluate the ability of the muscular flap preventing infection with devascularize bone in rabbit. Methods:The quadriceps femoris muscle of rabbit was excised to expose the anterior femur,subsequently, 1.5 cm× 0.4 cm segment of devascularize bone was havested and dipped in 0.2 ml solution containing 5×10 5 bacteria for half hour, then returned to its original position.the rectus abodominis muscle flap based on inferior epigastric artery or the epigastric skin flap base on superficial artery was elevated and covered the wound of thigh. The leucocyte from blood and bacteria quantity from segment of devascularize bone were measured. Results:Compared with the skin flap,the leucocyte concentration and bacterial quantity was lower in muscular flap. Conclusion:The island muscular flap is more excellent method of inhibition and elimination of bacteria in infectional bone.