Primary Study On The Effects Of Limbs Periosteum In Open Soft Tissue Injury With Seawater Immersion

ObjectiveIn the naval and landing operations, the limbs and opening up wounds are the most common injury type, often accompanied with seawater immersion. A variety of sea accidents, the flight crashed at sea, diving operations, submarine escape, and the offshore drilling platform, the objective conditions of the accident, officers would inevitably be not subject to seawater immersion wound, in particular limb immersion. Sea water temperature is low, containing sodium chloride 0.53 ~ 0.58 mol / L (3l ~ 34 g / L), pH 8.0 ~ 8.21, is hypertonic, strong alkaline liquid, with special physical and chemical properties, and contains nearly 20 species on the human body obviously pathogenic bacteria. When the infection rate of open fractures with seawater immersion increased callus generated delays callus formation poor, delayed healing, fracture healing strength was significantly lower than the control group. Periosteum the occurrence and growth process in the bone plays an important role in periosteal bone is the periosteum of the main function of the germinal layer of cells needed to have a fracture healing. This research project seawater immersion in an open soft tissue injury to the periosteum impact. In this experiment, rabbits open soft tissue injuries with seawater immersion wound in experimental models periosteum taken to do histological observation and detection of Limbs periosteal expression of related cytokines to explore the seawater immersion on the impact of long bone periosteum and mechanism, with a view to open seawater immersion-related injuries and provide a theoretical basis for clinical treatment. Materials and MethodsRabbits two hindlimbs'soft tissue were subjected to moderate open injury to severe severity. Pathological changes of limbs periosteum was observed by hematoxylin and eosin method at designed time points(Od,1d,3d,7d) after BMPs/VEGF/ TNF-α/TGF-β1 proteins expression was detected by immunohistochemistry.Results(1)The degree of hyperinflammation in the immersion group were more severe than that of the simple wound group. The longer the immersion time , the more severe the wound was.(2)There was no significant difference in the periostcal malpighian layer cell between B group and A group ,meanwhile between C group and A group instantly after injury (P>0.05),while there was significant difference between B group and A group, meanwhile between B group and C group at 1 day,3 days,7 days after injury(P<0.01) for the periostcal malpighian layer cell of B group increase obviously; there was no significant difference between C group and A group though the amount of periostcal malpighian layer cell of A group more than C group.(3)Membrane bone formation was delayed obviously with the seawater immersion for 1 hour, while it was not delayed obviously with the seawater immersion for 30 minutes.(4)The protein expression of BMPs and VEGF of periosteum in group C was later and lower than that of group A and B obviously, The protein expression of BMPs and VEGF of periosteum in group B was not later , while it was lower than that of group A.(5)The TNF-αprotein express in periostcal osteoprogenitor cell and osteoblast of three groups ,the expression reached the peak value at 1 day ,then gradually decreased. The longer the immersion time , the more expression amount and time of TNF-αprotein was. (6)The TGF-β1 protein express in periostcal osteoprogenitor cell and osteoblast of three groups in 0 day to 7days,which expressed in B group was more than in C group and A group obviously.ConclusionIn open limbs soft tissue injury with seawater immersion for 30 min, Membrane bone formation was not delayed obviously, the cellular proliferation and differentiation of periosteum osteogenic cell and Gegenbaur's cell was not influenced obviously, which was delayed obviously with the seawater immersion for 1 hour.Seawater immersion aggravates damage in periosteum,the limbs soft tissues open injury with seawater immersion for 1 hour could delay and damage the capability of membrane bone formation of periosteum,to deduce that the longest endurance time of periosteum with seawater immersion could be less than 1 hour.