| With the development of industry and agriculture, transport and production and construction, variety of patients with open injury or bone defect are increasing. treatment of large bone defects and infection after trauma is becoming a very difficult problem ,and repair of bone defect is greatly influenced by tissue infection after injury. With the development of marine industry, and to fulfill the need of medical support of military struggle in the Taiwan Strait, the research of tissue injury soaked by water is growing at present, however, there are no such research that study the repair and functional reconstruction of infected large bone defect soaked by water, furthermore, there are lack of reports that establishment of animal model of infected large bone defect soaked by water.This experiment is based on no related reports, we moved to the specific sea areas in coastal Fujian to undergo this comparative study of materials for repairing the infected large bone defect soaked by water. First, we established the animal model that infected large bone defect caused by open injury and soaked by water, two kinds of artificial substitutes that mostly used in repairing large bone defeat had been adopted to undergo this comparative study.The objective of this research is to compare the repair of infected soft tissue caused by soaked water or natural exposure and effects of using materials to repair large bone defect, and to provide medical supports for marine industry and military struggle. This research includes the following 4 aspects: firstly, we originally established the animal model that infected large bone defect caused by open injury and soaked by water. Dogs(either gender, weight 10-15kg) were selected, Radius of fore leg was isolated, then created a 2cm open bone defect in the middle of the radius, soaked by water to make bone defect infected, With all the procedure above done, the establishment of model was finished. Secondly , Preliminary investigation about The sensitivity of bacteria to antibiotics produced by infected and water-soaked bone defect caused by open injury specific sea areas in Fujian was carried out. The experimental group is soaked by water for 2 hours, the control group is been natural exposed 2 hours, then dressed the wound sterility, Observation of the wound after 3 days, took secretions for bacterial culture and drug sensitivity test to determine the infection. Antibiotic sensitivity test was carried out to select the most effective antibiotics to treat animal with infected bone defect and to guide the empirical and early use of antibiotics, and to gain valuable time for the treatment of infected bone defect soaked by water. Thirdly, by way of animal experiments, the repair of infected soft tissue caused by soaked water was observed. We observed the skin of infected wound that socked by water, the effect of repair and stability of the implanted materials. Fourflod table and Chi-square test was used for statistics, we concluded that the effect of wound healing of experimental group is worse than that of the control group. Fourthly, we underwent comparative study of effects of using artificial substitutes to repair infected bone defect soaked by water. All animals with infected bone defects soaked by water were allocated at random, then implanted Nano-hydroxyapatite(n-HA) or calcium phosphate cement(CPC) respectively. After 12 weeks, X-ray were taken respectively, The ends of bone were taken for pathology examination. Soft tissue was taken for HE stain, Bone specimens were fixed for VG stain. Granulation and fibrous tissue, callus of cartilage between ends of bone and materials and bone proliferation were observed by X-rays and pathological sections, and carried on pathological rating of soft tissue and growth grade of callus of bone ends. Factorial analysis was adopted to process the data, we concluded that there were different between experimental group and control group (P<0.05) through pathological results of soft tissue after 12 weeks, so does the same between n-HA group and CPC group, there are significant different in growth grade of callus of bone ends between experimental group and control group (P<0.01),so does the same between n-HA group and CPC group, there are no interaction between groups and materials(P>0.05).Results shows: According to the results of Bacterial culture, vibrio of bacteria can be seen in ocean water, with high Pathogenicity., By observing the healing of specimen, the wound healing of skin and soft tissue in water-soaked group is worse than that in the natural exposure group; comparing the healing rating of pathological tissue, effect of healing in experimental group is worse than that in the control group, Degradation of CPC is not bad in material repairing, Effect of ingrowth of new bone is better than n-HA bone; Growth of callus shows that quantity of growth in experimental group is less than that in the control group, Osteogenesis induced by CPC is better than induced by n-PA. we can conclude from all results that vibrio has high Pathogenicity and great harm when soaked by water, Seriously affect the infected wound healing, according to drug sensitivity test, Ciprofloxacin, penicillin and levofloxacin have a high Sensitivity rate against Cocci, bacteria and Vibrio, we can use those drugs as therapeutical drugs empirically before the outcome of drug sensitivity test; the effect of using artificial material to repair the infected bone defect soaked by water is poor;the effect of using implanted CPC to repair the infected bone defect soaked by water is better than using n-PA.Nowadays, within this two kinds of artificial substitutes that mostly used, CPC has a satisfactory effect of repair and promoting osteogenic growth, also provide a reference in selecting the materials to repair the bone defect. we originally established the animal model that infected large bone defect caused by open injury and soaked by water, it deserve popularize... |
PDF Full Text Request