颌面部高速投射物伤区软组织感染特点的实验观察

The Experimental Observation on Characteristics of Soft Tissues Infection\; in Maxillofacial Region Wounded by High Velocity Missile

用初速 15 0 0 m/ s,重 1.0 3g钢珠致伤 6只狗颌面部 ,伤后 6 ,12 ,2 4h取距伤道壁不同距离的肌肉组织做需氧及厌氧菌培养。实验发现 :颌面部高速投射物伤区 ,距伤道壁 0 .5 cm以内的软组织 ,伤后 6 h开始出现细菌感染 ,随致伤时间延长 ,感染细菌的数量明显增多 ,距伤道壁 0 .5 cm以外的组织 ,在伤后 2 4h,细菌的污染数量远远低于感染细菌的临界数量 ;感染或污染细菌的种类以需氧及兼性厌氧菌为主。研究提示 :颌面部高速投射物伤区组织存在明显的细菌感染 ,但其严重感染的区域在距伤道壁 0 .5 cm以内 ,从控制感染的角度清创时切除距伤道壁 0 .5 cm以内的软组织即可 ,扩大清创范围并不能起到控制感染的效果 ;而清创后应用有效抗生素是防治伤口感染 ,保证早期救治成功的重要措施。

In this experimental study, maxillofacial regions of dogs were wounded by steel spheres, which weight 1.03 g at a mean primary velocity of 1500 m/s. Aerobe and anaerobe bacteria in the muscles of different interval from wound track edge were cultured at different time after wound. The results showed that there was bacteria infection in the soft tissues between 0 and 0.5 cm from wound track edge in 6 hours after wound. The quantity of bacteria obviously increased following time prolonging, on the contrary,it was much lower than threshold value of bacteria infection within 24 hours. The experimental results suggested that there was obvious bacteria infection in the soft tissues within 0.5 cm distance from wound track edge in maxillofacial firearm wound region. During the debridement removing soft tissues within 0.5 cm distance from wound track edge, the infection of wound region could be controlled. Using effective antibioitcs is an important measure of controlling infection of wound after debridement.\;