海水浸泡创伤皮肤软组织病理变化特点及对组织移植修复伤口的研究

Characters of pathological changes of seawater-marinated skin soft tissues and wound repair with tissue grafting

目的:探讨肢体爆炸伤海水浸泡后皮肤软组织的病理变化特点,为海战伤中采用组织移植等修复方法处理伤口提供理论依据。方法:实验于2003-09/11在西京医院实验动物中心完成。选用纸壳爆破雷管炸伤家兔后肢,将致伤家兔分别置于海水中浸泡30min和1h,并分别在浸泡后2,6,12h取材,肉眼、光镜观察组织形态变化,并与单纯爆炸伤和淡水浸泡组进行比较。结果:肢体爆炸伤海水浸泡后皮肤损伤程度、范围以及炎症反应明显重于单纯火器伤组;浸泡时间越长,组织损伤越重;海水浸泡后嗜酸性粒细胞明显增多,与单纯火器伤组和淡水浸泡组有明显区别。结论:爆炸伤后海水浸泡不但加重了皮肤组织的继发损伤,而且伤口全部感染,并可见大量嗜酸性粒细胞,对海战中抗生素的应用和采用组织移植等修复方法处理伤口有一定的指导意义。

AIM:To investigate the pathological changes of seawater marinated skin soft tissues in extremities with blast injury so as to provide theoretical bases for the wound treatment by using repairing methods of tissue grafting,etc.in naval battles.METHODS:The experiment was conducted in the Center for Experimental Animals in Xijing Hospital from September to November 2003.Rabbit rear limbs were wounded by paper shell detonator and subsequently marinated in seawater for 30 minutes and 1 hour respectively,whereafter,the morphological changes of the samples were observed with naked eyes and under light microscope 2,6,and 12 hours respectively after being marinated.Then,the morphological changes of seawater marinated samples were compared with those of freshwater marinated and single firearm wounded ones. RESULTS:Obviously,compared with the firearm wounded group,the detonation caused wound after being marinated in seawater was more serious in terms of damage extent,area and inflammatory reaction.The tissue damage got worse with the marinating time and there was an obvious increase in the number of eosinophilic granulocytes in seawater marinated group,which was apparently different from those in freshwater marinated group and firearm wounded group.CONCLUSION:Seawater marination of detonation caused injury not only worsens secondary injury of skin tissue,and makes the general infection of wound with a great number of eosinophilic granulocytes,which guides the application of antibiotic and repairing methods(tissue grafting,etc.) for the wound treatment significantly in naval battles.