| In warfare, the extremities are the anatomical regions most commonly injured by explosive munitions, such as bombs, artillery shells, grenades, or land mines, etc. The injuries of extremities are the most common type of wounds, accounting for 40% to 70% of all wounds. In addition to their direct wound effects, the explosive force from these weapons also drives fragments and foreign material into soft tissues, potentially causing secondary infection.Severe contamination and delayed medical evacuation are the norm. The quality of care provided for the patients with blast and fragment injuries depends on following the basic tenets of war wound surgery, which include meticulous wound debridement, adequate drainage, and antibiotics. The importance of timely applied antibiotics cannot be overemphasized. The injuries should be treated surgically with concomitant use of antibiotics, early and appropriately. The mortality and disability of wounded soldiers have increased in battlefield condition because medical treatment cannot be provided timely. As this, we established this experiment to investigate the therapeutic effect of sustained release compound tablet contained anti-bacterial and anti-inflammatory drugs on explosive wounds.In this study, the ideal explosive model was established by shooting hind limbs of rabbit with steel sphere combined with detonator explosion. It was constructed with the same steel sphere velocity and blast pressure controlled by instrument. We designed a novel tablet, which contains antibiotic (ciprofloxacin) and ant-inflammatory drug (diclofenac sodium). Chitin and Carbomer as framework material of the tablet were selected to constantly release the drugs. This tablet was made by the mechanical compression directly. The rabbits were divided randomly into 3 groups after injury. The control group (CG) was not performed any treatment.The debridement group (DG) was performed routinely. This tablet was put into the wound tract of treatment group (TG). The data of systematic and tissue topical condition of wound tract were collected to compare the difference of the characters of inflammatory response and secondary injuries at post-injured different intervals. Based on the evidence that the secondary injuries, hyper-inflammation and infection were serious, the release properties of the sustained release tablet were measuredin vitro and in vivo; The changes of the histopathology, inflammatory media (TNF-a, IL-6), the pressure of oxygen, superoxide dismutase(SOD), bacterial number, and resected necrosis tissue weight were measured and monitored.The results of study showed that the inflammatory media (TNF-a, IL-6) in CG significantly increased compared to TG and DG after injury, TG and DG had no statistical difference after 12 hours. The pressure of oxygen in the CG was lower than TG and DG after 12 hours,TG and DG had no statistical difference. Colony forming unit (CFU) of bacteria was less in the TG than in the DG. Superoxide dismutase (SOD) had no statistical difference in the TG and DG after 12 hours.The resected necrosis tissue weight in the TG was more than in the DG, but had no obvious statistical difference. The inflammatory changes of histopathology can be observed in 3 groups, such as the infiltration of cell and edema in 3 groups, but in the TG it was less than in the CG and the DG.The conclusion can be obtained from the study: 1.The lesion of tissue and secondary injury caused by hyper-inflammation is serious and the happening of infection is easy in explosive wounds. 2.This tablet can released constantly the drugs for 36 hours and the concentration of the drugs in tissue reached the requirement. 3.Diclofenac sodium can relieve hyper-inflammatory response and secondary injuries by restraining the production of inflammatory media and reducing the infiltration of inflammatory cell. Ciprofloxacin can delay the happening of infection. Thus, we concluded that this new tablet has great practical value in early treatment toward explosive wounds.
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