颌面部火器伤区软组织清创及伤口愈合的实验观察

ESPERIMENTAL BOSERVATION OF DEBRIDEMENT OF SOFT TISSUES AND WOUND HEALING IN MAXIOLLOFACIAL FIREARM WOUND REGION

实验用犬14只,用质量1.03g,平均射速1434m/s的钢珠弹致伤颌面部。分别于伤后6h、24h清创,清创时肌肉组织的切除范围为0.5cm,创口初期缝合,一周内肌注抗生素预防感染。观察创口愈合及创缘肉芽组织细菌污染情况。结果显示:①在本实验致伤条件下,清创范围为0.5cm,清创后初期缝合,其伤口一期愈合率为94.4％;②在伤后6h和24h清创,伤口愈合情况和伤道肌肉组织羟脯氨酸含量无显著差异,但伤后6h清创可减少局部组织的细菌污染程度;③清创后应用足量有效抗生素是预防伤口感染,保障伤口愈合的重要措施。

Fourteen dogs were used. The maxiolloiacial regions of the dogs were wounded by a steel sphere weithting 1. 03 g with a mean impacting velocity of 1434 m/s. The debridement were performed at 6 h and 24 h after the wounding. The muscle tissues within 0. 5 cm of the wound was performed. Antibiotics were used i. m. in a week, to privent the infection of the wound. The course of wound healing and the number of the bacterial infection in granulation tissue were observed. The experimental results showed: (1) Under this experimental wounding conditions, if debridement range of muscle tissues was within 0. 5 cm of the luond tract wall and primary suture of the sound was per-formed, the rate of primary healing of the wound was 94. 4% ; (2) When debridement was performed at 6 h and 24 h after the wounding, the course of the wound healing and the concentration of hydroxpro-line in the grnulation tissues were not significant difference, but the number of bacterial infection in regional granulation tissue reduced significantly when the debridement was performed at 6 h after the wounding ; (3) Using sufficient and effective antibiotics was an important method to prevent the infection of the wound and ensure the wound healing.