负压封闭引流联合灌洗治疗感染软组织火器伤早期疗效的初步实验观察

Effect of vacuum sealing drainage with irrigation in the treatment of the infected firearm wounds

目的探讨负压封闭引流(VSD)联合灌洗治疗感染火器伤的早期疗效。方法 18头猪枪击致伤右后肢,前2天不做任何治疗以造成感染火器伤。第3天行有限清创后,随机分为对照组(常规处理)、VSD组和实验组(VSD联合灌洗治疗),每组6头。比较3组各时间点伤道细菌计数、外周血中白细胞和内毒素含量的变化,并行常规病理学观察。结果与对照组和VSD组比较,实验组伤道细菌计数、外周血白细胞和内毒素含量迅速下降,病理学显示组织炎症反应明显减轻、组织修复快。结论采用VSD联合灌洗对感染火器伤进行早期救治,能迅速控制感染,减轻全身反应,为尽早修复重建创造良好的软组织条件。

Objective To study the early effect of vacuum sealing drainage（VSD） with irrigation on the infected firearm wounds.Methods Totally 18 pigs were shot in the right hind,and all the wounds were untreated until the third day after injury.Pigs were divided randomly into control group,VSD group and experimental group（n=6/group）.The control group was treated with conventional therapy,experimental group was treated with VSD combined with irrigation.Bacterial counts of wound tract,the level of leukocytes and endotoxin in peripheral blood of three groups were detected at different time points after different treatments,and the conventional pathology observation was performed.Results Compared with the control group and VSD group,bacterial counts of wound tract,the level of leukocytes and endotoxin in peripheral blood dropped rapidly.The results of pathology showed that inflammatory response reduced,tissue repair accelerated.Conclusion Application of VSD with instillation for treatment of infected firearm wound can rapidly control infection,reduce the systemic response,create a good soft tissue conditions for repair and reconstruction as early as possible.