| Background:Naval battle is the main forms of modern warfare, as a large number of high-tech weapon's use which are more powerful than ever before; plus small space for ships and personnel-intensive, which may lead to a large number of wounded in a wink. During the sea warfare, people have to abandon ships to escape with their lives when their warships damaged, so the wounds are inevitable to be immersed by the seawater. China's navy has no large-scale experience of modern naval warfare. However, in recent years due to Taiwan independence forces more and more rampant, the future naval battle broke out the possibility of significant increase. In order to response to this challenge, our army has increased the research of modern war injuries'treatment, and hurt by seawater is one of the focuses research. After years'study on injuries by seawater immersion, injuries have been characterized by a certain understanding.As the sea water with low temperature, hypertonic, alkaline, rich in pathogenic micro-organisms characters, which making the injuries by seawater immersion different from the injuries in general damages to cause more severe pathological and physiological changes.If the seawater goes into the body cavity, the water can directly cause organ damage and form the oppression to the important organs like heart and lung, which would cause more serious harm to the body and a serious threat to the lives of the wounded. Penetrating abdominal injury widely see in the common war wounds were caused by projectiles hit which lead to the abdominal peritoneal cavity connected with the outside world. Currently the study of changes in the pathophysiology for these injuries merge by seawater immersion is not extensively.In addition, in view of the serious damage caused by seawater immersion, it is important to take effective measures to prevent seawater directly on the wound; thereby blocking seawater immersion led to a series of physiological and pathological changes to help wounded people create the essential condition for success treatment.At present, the normal triangular bandage with a pressure function, which has played an important role in the treatment of war wound for a long time; but due to the lack of waterproof function which has low value in wounds treatment of naval battle.At present, none of foreign armed forces and our military has the equipment can be used to prevent seawater soaking the wounds.Objective:(A) To observe the changes of water-electrolyte, acid-base balance, blood flow dynamics and major abdominal organs of penetrating abdominal injuries in dogs with seawater immersion, and to provide a theoretical basis for treatment on injuries by seawater immersion.(B) To develop waterproof triangular bandage, and to verify its waterproof performance, and offer our military with the new equipment applied in self-help and each other in the naval battle.(C) To observe the hemodynamic and physiopathologic changes in dogs with penetrating abdominal injury and seawater immersion after dressing waterproof triangular bandage, and further evidence that seawater into the abdominal cavity is the main factor in body leading to serious pathological changes.Methods:(A)Using of 20 adult dogs with weighing from 13.7kg to 19.5kg, were randomly divided into control group (injury without immersion, n = 10) and immersion group (immersed after the injury, n = 10).Control group, making penetrating abdominal injury animal models didn't entering by seawater, and the immersion group into the artificial sea water immersion.The anatomized animal neck vein and artery after a narcotic, were placed 5-F artery catheter and the four-chamber thermodilution Swan-Ganz catheter, on the abdomen to do 3cm long incision, in the rectus abdominis buried in shallow 3 Quantitative point source explosion, set off and caused abdominal wound size of 3×1cm. Monitoring injury after injury before and 4h to reflect changes in the hemodynamics of the main indicators of MAP, CVP, CO, and so on, arterial blood samples to test before the injury and after injury 1 ~ 4h Na+, Cl-, pH value, HCO3-, PCO2 and Plasma osmotic pressure and other biochemical markers of the main, and after the experiment to observe the major abdominal organs liver, kidney, small intestine pathological changes. Compare the results of the two groups. (B) The development of waterproof triangular bandage: with Jiangxi 3L's cooperation in the development of waterproof triangular bandage. The waterproof triangular bandage designed with 6-layer structure and 7 kinds of raw materials. The anti-immersion experiments were done in 5 different seas with 169 Navy fighters. Observing its water-blocking effect and the local skin allergic reactions occurred after 2h escape simulation in the sea with waterproof triangular bandage on abdominal wound.(C) 20 adult dogs with weighing from 14.5kg to 18.6kg were randomly divided into waterproof bandage group (after the injury dressing waterproof triangular bandage , n = 10), and ordinary bandage group (after the injury dressing bandage general, n = 10), making the same penetrating abdominal injury animal models as method A,and monitoring and observing the same hemodynamic and physiopathologic changes.Compare the results of the two groups.Results:(A) There's obvious physical disorder and severe pathological changes on the dogs with penetrating abdominal injuries merge seawater immersion. During the immersion, it shows that the MAP, CVP, CO, pH value, and HCO3-continuous keep declining among the experimental immersion group, and the sodium, chloride and blood plasma osmotic pressure is gradually increased. Soaking in water longer, the more serious of these changes will appear. Liver, small intestine and kidney also apparent pathological changes. In the control group, only minor changes. Control group of animals all survived during the experiment, the survival rate of animals immersion group only 50%.(B) The successful development of a waterproof triangular bandage. There were 169 people took part in anti-immersion experiment, the effective rate was 95.9 percent, and all personnel without the occurrence of skin allergy.(C) During experiment the general bandage group's MAP, CVP, CO, pH value, HCO3-, sodium, chloride and blood osmotic pressure in plasma immersion trends and changes are same with the immersion group. By seawater immersion, the liver, small intestine and kidney also have apparent pathological changes; however, the occurrence of the disorder pathophysiology of the extent of a little light. The waterproof bandage group in the above-mentioned targets during the experiment, only minor changes in the liver, small intestine, kidney also has to maintain the basic structure of the normal tissue. Waterproof bandage animals in the experimental group, the survival rate was 100%, ordinary bandage group survival rate was 60%, waterproof bandage group of animal survival rate was significantly higher than that of ordinary water and bandage group.Conclusion:(A) Abdominal penetrating injuries after seawater immersion would cause high sodium, chloride, hypertonic, severe metabolic acidosis, and severe hemodynamic disorders, liver, small intestine, kidney would have serious pathological changes.(B) The unique structure of the waterproof triangular bandage can tolerance seawater immersion during the long time escape. It doesn't open plastic with a reliable water-blocking features in the next naval battle an important value.(C) Waterproof triangular bandage on penetrating abdominal wounds are obvious protective effect, can be effective in preventing seawater into the abdominal cavity, thus avoiding the hemodynamic disorder, electricity and acid-base disorders caused by water. And to prevent water damage to the abdominal organs, prevent pathological changes.At the same time, it also confirmed that the seawater into the abdominal cavity is the main factor leading to serious pathophysiology disorder.
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