摘要
目的:观察感染对猪皮肤软组织爆炸伤创面继发性坏死范围的影响.方法:用电雷管在6只15~20kg的小自家猪双侧肩胛及双侧臀部造成24个爆炸伤创面。随机分为A组和B组,每组3只动物,12个创面.A组创面伤后前3d每日常规换药,B组创面伤后前2d不做任何处理,以造成创面感染.伤后第3d,两组均常规换药.结果:伤后6h创面平均面积为(7.34±0.99)cm^2,创面平均深度(0.85±0.126)cm,两组创面面积和深度的差异无统计学意义(P〉0.05).伤后3d,A组创面内的细菌数(0.157±0.171)×10^5细菌形成单位/克组织(cfu/g),B组创面内的细菌数(323.417±30.631)×10^5cfu/g,两组差异有统计学意义(P〈0.01),B组创面面积和深度分别(10.81±0.32)cm^2和(1.66±0.09)cm,A组创面面积和深度分别(9.17±0.60)cm^2和(1.43±0.13)cm,B组创面面积和深度均较A组大(P〈0.01);伤后6d和9d,B组创面深度加深至(2.42±0.22)和(2.46±0.25)cm,创面面积扩大至(13.33±0.46)和(11.38±0.39)cm^2,深度较伤后3d深约1cm,创面边缘皮肤较伤后3d扩大约0.5cm,伤后6d和9d的创面面积及深度均和B组伤后3d差异有显著统计学意义(P〈0.01).结论:感染能加重和导致爆炸伤继发性坏死;在常规治疗的干预下,感染能造成猪皮肤软组织爆炸伤感染创面深度约1cm深部组织和伤口周围约0.5cm皮肤发生继发性坏死.
AIM: To observe the influence of infection on the secondary necrosis of soft tissue blast injury in pigs. METHODS: Twenty-four blast wounds, created by explosion of a specific type of electric detonators which were fixed at 1 cm over the skin of the shoulders and hips of 6 small white domestic pigs (15 -20) kg, were divided into 2 groups: group A which was treated with conventional dressing change, and group B which was not treaed until the 3rd clay after injury. Tissue specimens, collected from the wounds on day 3, 6, and 9 after injury, were weighed and underwent bacteria counting. Meanwhile, the wound areas and depths were measured on the corresponding time points after injury. RESULTS: Six hours after injury, the mean area and depth of all wounds were ( 7.34 ± 0.99 ) cm^2 and ( 0.85 ± 0. 126) cm, without statistical significance between group A and B in both wound area and depth ( P 〉 0.05 ). Three days after injury, the bacteria load, area, and depth of the wounds in group A were (0. 157 ± 0. 171 ) × 10^5 colory-forming unit/g ( cfu/g), (9.17±0.60) cm^2, and (1.43 ±0. 13) cm, while those in group B were (323.417 ±30.631) × 10^5 cfu/g, (10.81 ±0.32) cm^2, and ( 1.66 ± 0.09) cm, respectively, showing significant statistical differences between group A and B in the three definite measurements of wounds (P 〈0.01 ). Wound areas of group B on day 6 and 9 after injury were ( 13.33 ± 0.46) and ( 11.38 ± 0.39 ) cm^2, both being significantly different from those of group B on day 3 after injury (P 〈0.01 ). Wound depths of group B on day 6 and 9 after injury were (2.42 ±0.22) and (2.46 ± 0.25 ) era, both of which had significant statistical differences as compared with those of group B on day 3 after injury ( P 〈 0.01 ). CONCLUSION: Infection aggravates the secondary necrosis of soft tissue blast injury, and under the treatment of conventional dressing change, infection can cause about 1 cm tissue in the wound and the about 0. 5 cm skin around the wound to necrosis.
出处
《第四军医大学学报》
北大核心
2007年第4期324-327,共4页
Journal of the Fourth Military Medical University
关键词
爆震伤
感染
继发性坏死
blast injuries
infection
secondary necrosis