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目的:观察封闭负压引流(VSD)对猪肢体枪弹软组织贯通伤初期治疗的效果,为临床枪弹伤早期救治提供理论依据。方法:选取兰州地区健康成年长白约克品种猪8只,用95式步枪射击致双后肢贯通伤,距离25m。致伤后将两双后肢自体左右配对,分成VSD组和对照组。两组致伤6h行弹道清创消毒。分别在致伤后不同时间作细菌学计数,行病理学检查,5、72h行彩色多普勒超声检查。结果:治疗后细菌学计数两组比较差异有显著性(P<0.05),病理学VSD组较对照组肉芽组织丰富,且炎细胞浸润、肌组织溶解变性及弹道表面菌落不明显。72h超声检查VSD组较对照组弹道及周边红蓝血流信号丰富,并见断裂肌束逐渐恢复。结论:VSD可降低枪弹软组织贯通伤细菌数量延缓感染时间、促进肉芽组织生长及局部血流量、减少创周组织水肿及降低血管通透性。
OBJECTIVE: To observe the effect of closed negative pressure drainage (VSD) on the initial treatment of bullet-soft tissue penetrating injury in swine limbs and provide a theoretical basis for the early treatment of clinical bullet wounds. Methods: Eight healthy Yorkshire Yorkshire breeds were selected, and a total of 8 hemi - hindlimb injuries were caused by 95 - type rifle shot. After injury, the two pairs of hindlimb self-paired, divided into VSD group and control group. Two groups of 6h traumatic debridement debridement. At different times after injury, bacteriological count, pathological examination, 5,72h line color Doppler ultrasound. Results: The bacteriological counts after treatment were significantly different between the two groups (P <0.05). The pathological VSD group was more rich in granulation tissue than the control group, and inflammatory cell infiltration, muscle tissue degeneration and alteration were not obvious. 72h ultrasonography VSD group than in the control group and the surrounding red and blue blood flow signal enrichment, and gradually recover the broken muscle bundle. CONCLUSIONS: VSD can reduce the number of bacterial transfusions in gunshots and soft tissues, delay the time of infection, promote the growth of granulation tissue and local blood flow, reduce the edema of peri-invasive tissues and decrease the permeability of blood vessels.