负压封闭引流技术治疗爆炸伤致猪全层腹壁缺损的实验研究

Research of treating blast injury wound-induced abdominal wall defects in pigs with vacuum sealing drainage

目的:探讨负压封闭引流技术(Vacuum Sealing Drainage,VSD)对于爆炸伤导致的全层腹壁缺损后的疗效。方法:20只健康家猪制作腹部爆炸伤开放模型随机分为两组。所有创面均在伤后6～8h内清创,实验组将带孔硅胶膜覆盖于脏器表面后应用VSD敷料进行治疗,压力设定于-125mmHg,对照组将硅胶膜覆置于脏器表面,盐水纱布覆盖包扎,常规换药,比较两组修复前时间,换药次数,创面及腹腔感染率。结果:实验组修复前时间为(7.20±2.39)天,换药次数为(2.20±0.79)次,创面及腹腔感染率为10%;对照组修复前时间为(10.30±2.11)天,换药次数为(11.90±2.23)次,创面及腹腔感染率为70%。两组各项比较均有统计学意义(P<0.05)。结论:VSD治疗对于爆炸伤导致的全层腹壁缺损能缩短治疗时间,有效控制创面及腹腔感染,减少换药次数。

Objective To explore the effects of vacuum sealing drainage（VSD） for blast injury wound-induced abdominal wall defects in pigs.Methods Twenty small white domestic pigs models of exlposive abdominal wounds were divided into two groups.All wounds were debrided within 6-8 hours of injury.Group A set the pressure at-125mmHg,VSD therapy was applied to the abdomen by placing a fenestrated silicone sheeting over the abdominal viscera.Group B treated with silicone sheeting,which was covered with a salinesoaked gauze dressing that was changed several times daily.Duration of treatment,days of preoperation,times of dressing,the ratio of soft tissue infection and intraabdominal infection were compared between two groups.Results In VSD group,days of preoperation were（7.20±2.39）days,times of dressing were（2.20±0.79）,the ratio of soft tissue infection was 10%,intraabdominal infection was 10%.In non-VSD group,days of preoperation were（10.30±2.11）days,times of dressing were（11.90±2.23）,the ratio of soft tissue infection was 70% intraabdominal infection was 70%.There were significant differences in the preoperative days,dressing times,the ratio of soft tissue infection and intraabdominal infection between 2 groups（P0.05）.Conclusion It is effective to apply VSD to management blast injury would-induced abdominal wall defects,which can shorten the preoperative days,cut down infection rate,decrease times of dressing.