Research On The Mechanism Of Secondary Thrombosis After Skin Avulsion Injury And Clinical Treatment

Skin avulsion injury with the complex conditionof an injury and a high rate of compound wound and secondary necrosis of avulted tissue is one of the common traumas. Shortage of effective techniques for judging the blood circulation in avulsed tissue and the complexity of mechanism of tissue necrosis have made to some extent a difficult treatment. Therefore it is of great significance to study the mechanism of avulsed tissue necrosis and to come up with an ideal treatment for skin avulsion injury. An ideal treatment is to save viable avulsed tissue. However, secondary avulsed tissue necrosis caused mainly by avulsed tissue thrombosis in tissue vessels happens when viable avulsed tissue determined during operation turns out to be tissue necrosis after operation. So avulsed tissue thrombosis in tissue vessels is the focus of the research done by many worldwide researchers.In this study, a 12cm× 4cm random avulsed flap was created in hind leg of pig by mimicking the mechanism of causing avulsion injury and by applying the avulsion-injury-created machine. Post-injury tissue pathology and the amount and the change of TNF_α, IL-1,TXA₂/PGI₂, GMP-140 in vessels were made known by infiltrating HE, ELISA, ³[H]-TdR and radioactivity immunity determination. The results showed that there were injuries at different levels in skin, in dermis tissue and vessels. Thrombosis and hemorrhage could be found in some vessels. TNF and IL-1 in plasma were increased distinctively, so was TNF_a in avulsed flap. They were 415 ng/1 +24ng/l, 2.59+1.85(p<0.01) and 298+18.5ng/L(p<0.01) respectively after three days. TXB₂ and 6-keto-PGF_1α in the distal part of the avulsed flap were 2.76 and 2.01...