DDS在海水浸泡四肢软组织火器伤中的应用

Local application of drug delivery system to the firearm wounds of soft tissue in rabbits with seawater immersion

目的 观察药物缓释体(DDS)在肢体软组织火器伤合并海水浸泡伤区的作用。方法 采用初速度600～800m/s,0.38g钢珠弹或0.05g DNP小型点爆源致伤兔股后区软组织,并置于人工或天然海水中浸泡1小时,随后在实验组伤道置入DDS1枚。于伤后6、12、24、36小时观察伤道大体变化,并分别切取骨骼肌组织进行抑菌实验、病理学检查和细菌培养。结果 DDS对常见病原体如金黄色葡萄球菌、大肠杆菌和绿脓杆菌有强而持续的抑菌作用。与对照组相比,实验组伤区污染菌数和炎细胞浸润数均明显减少,且未见脓液形成。结论 DDS是预防火器伤合并海水浸泡伤道细菌感染的一种有效措施;局部使用DDS后,可以将外科清创时间延迟至36小时,故适宜于海战中的救治工作。

Objective To observe the effect of drug delivery system ( DDS) on soft tissue wound in the limbs by firearm and seawater immersion. Methods The soft tissue region of rabbis'thighs were wounded by steel spheres of 0. 38 g with primary ve-loctiy 600-800 m/sec or small explosive device of 0. 05 g DNP and were soaked in artificial or natural seawater for 1 hour. After this, one DDS,tricalcium phosphate delivery carrier with ciproflocine and tinidazole, was put in the wound track of rabbit in the study group. No DDS was placed in the control group. The samples of the skeletal muscle were excised from the sites around the wound tract 6.12,24 and 36 hours after the injury respectively. The changes of wound tract and histopathological alterations in the two group were observed. And the bacteriostasis test and bacterial culture in the study group were performed. Results DDS showed great and lasting bacteriostasis to common pathogens, such as stophylococcus arureus, escherichia coli and pseudomonas aeruginosa. The quantity of polluting bacteria and inflammatory cells around the wound region in the study group were decreased obviously. No bacteria infection was found there when compared with the control group. Conclusions DDS local administration to an firearm wounded tract with seawater immersion was an efficient prophylaxis of bacteria infection of wound. It may allow surgical debridement to be delayed for hours after wounding, without additional risk for the war cusulties.