The Experimental Study On The Application Of Vacuum Sealing Drainage Combined With Limited Debridement In The Early Recue Of Soft Tissue Blast Injury In Limbs

Objective To valuate the effect of the application of vacuum sealing drainage (VSD) combined with limited debridement in explosive soft tissue wounds in limbs.Method Twelve blast wounds, created by explosion of a specific type of electric detonations which were fixed at 1 cm over the skin of the hips of six Lanzhou healthy pigs (30-40kg),were divided into two matched groups. Debrided aggressively after 6hours injury, group A was treated with conventional dressing change, and group B was debrided limitedly and treated with VSD with the pressure of-20kpa. Tissue specimens collected from the different sites of wound bed before treatment and at the time of 12h,24h,48h,72h after treatment, and underwent bacteria counting. Color B-mode ultrasonic diagnostic equipment, magnetic resonance imaging and histological examination were used before treatment and after 72h treatment.Result The difference of wound bacteria loads between group A and group B was significant statistically at different times respectively after treatment. Bacteria loads in group B increased to 105cfu/g at 48h after treatment, within 24h in group A, and were not up continuously. The sings of blood flow in blast wound weren't measured before treatment. In group B, compared with the control group after 72h treatment, the blast wound had more a plenty of sings of blood flow, and less thrombus in blood vessels. The structure of vascular endothelial cells was more regular. The edema of blast wound was defined, and the anoxia skeletal muscles were less (P<0.05)Conclusion 1.VSD could restrain the bacteria proliferation, reduce the bacteria loads, and delay the time of infection.2. VSD could reduce thrombosis in blood vessels, repair the vascular endothelial cells, and improved the microcirculation of the acute blast wounds.3. VSD could alleviate the edema of blast wound and improve the anoxia skeletal muscles.4. The effect of VSD combined with limited debridement could early treating explosive soft tissue wounds in limbs was excellent.