| Objective：In this experiment, through the establishment of therabbit deep second-degree scald wound model, using the moisturizingdressings of TenderWet and Hydrocoll to Treat the rabbit deepsecond-degree burn wound，was to study the wet dressing on the deep Ⅱdegree burn in rabbits of acute wound healing effect mechanism, And toexplore the moisturizing dressing treatment technology applicationprospect. Methods: The subjects were24healthy New Zealand rabbits，in either gender, each with a body mass from2.5kg to3.5kg, obtainedfrom Laboratory for Animals of luzhou Medical college. Built4deeppartial thickness burn wound model in the rabbit back sides to spine asthe axis of symmetry，the2wounds on the back of right side of eachrabbit were into experimental (group A: treated with TenderWet, andHydrocoll combined application of), the2wounds on the back of leftside were into control group (group B: treated with1%SD-Ag creammoist gauze bandaging), each with48wounds. Preoperative1d, rabbits’back were depilated200cm2,1%pentobarbital sodium was injectedinto the auricular veins for anaesthesia of rabbits with the dosage of30mg/kg, were fixed in prone position, the rabbit back spine with gentianviolet painted lines on both sides of the rabbit spine, the symmetric partwas marked the wound position as the diameter was5cm，0.5%of diluted povidone-iodine was used to disinfect the skin, then used electronicthermostat perm instrument90℃,15seconds made of diameter5cm sizecircular deep Ⅱ degree burn (wasproved by pathology), each scaldedrabbits had4wounds, zygomorphic, a total of96wounds. observed thewound exudate within6postburn hours (normal NS debridement),group A after injuried, first,2th,3th,4th,5th,6th,7th days ofcontinuous use of diameter5.5cm TenderWet covered the wound,topical Hydrofilm fixed dressings,24hours changed dressings once;eighth,10th,14th,17th,19th,21th days respectively use Hydrocoll tocontinue change dressings of A group, Hydrocoll was cut according tothe wound size; the group B was treated with1%SD-Ag cream moistgauze bandaging with1layer, dressing processing time was the same tothe group A. The naked eye observed the two groups，generally changeand healing of the wounds, measured the wound healing rate according tothe scale; At2th,5th,7th,10th,14th,21th days,one rabbit was selectedto been operated, then obtained the wound tissue specimens in group Aand group B, then the rabbit were put to death. Each specimenorganizations to take100mg for the content of the acid hydrolysisdetected in wound tissue hydroxyproline (OHP); the remaining tissuesspecimens fixed in4%paraformaldehyde solution24h, dehydratedparaffin section, wound tissue in leukocyte infiltration，fibroblast cell,epidermal cells and fibroblasts growth, capillary number and collagen fiber hyperplasia were observed on light microscopy. Results:1.Grossobservation: experimental group A after injury on wound sustained wetstate, After injury, the third day, around the wound, congestion andedema subsided, the wound of necrotic tissue crust was soft, wound edgeepithelial cells crawling was visible; After injury, the fifth day，partialcrust dissolved and light red wound substrate was visible, there had mildinflammatory response around the wound and a small amount ofepithelial tissue crawling; After injury, the seventh day, the group Awounds was moist, crusts continued to dissolve, crust shell wasincomplete, and the thin soft，partial crusts attached more closely to thewounds was difficult to remove, visible reddish basement, seen about19%of the wound epithelium covering; After injury, the tenth day, thenecrotic scab dissolved, when the TenderWet dressing was replaced,bright red granulation Organization crawled had not healed wounds，further growth of epithelial tissue around the wound, about40%ofwound healing was observed. After injury；the fourteenth day, in groupA，the wound was moist, clean, about80%of wound was covered withepithelium, healing wound at the edge a small amount of hair growth，bright red granulation Organization crawled had not healed wounds. Afterinjury, the seventeenth day, in group A, the wound was moist, newbornepithelium covered almost98%of the wound, healing the wound seen asmall amount of hair growth, few wounds was not completely healed, epithelial cells spread in to the granulation tissue. After injury, thenineteenth day，in group A，the wound was moist，the wound was coveredwith newborn epithelium completely, and has a small amount of hairgrowth，the wound was basic complete healing，the Hydrocoll treatmentwas end. The group B, after injury, the third day, the wound relativelydry, had yellowish-brown crust shell formation，around the wound，congestion and edema subsided, wound edge epithelial cells crawling wasvisible; the group B, After injury, the fifth day, the wound was dry,yellow-brown crust shell covered the wound surface, there hadinflammatory response around the wound obviously and a small amountof epithelial tissue crawling, the group B, After injury, the seventh day,the wound was dry, black-brown crust shell covered the wound surface，seen about10%of the wound epithelium covering; the group B，Afterinjury, the tenth day, the wound was dry, crust shell peripheral portion ofwound was separated，had a small amount of secretions, the wound edgewas covered with newborn epithelium, about35%of wound was healing,After injury, the nineteenth day, crusts of wound was off completely,about90%of wound was healing，not healed wounds was covered withbright red granulation Organization, with punctate epithelial, thetwenty-first day，the group B，it was basic healing，only left small amountof stove shaped residual burn wounds the mean value of wound healingtime in group A was (17±2.6), in group B was (21±1.8), group A and group B(p<0.05).2Content of Hydroxy proline in the burned wound：After injury, the experimental group, content of OHP of the woundcontinued to increase from the third day on, and reached its peak（0.535±0.033μg） at the tenth day, as the wound healing, then graduallyreduced to normal；after injury，in the control group, OHP levelsincreased delay than the experimental group, OHP increased significantlyat the fifth day after injury, and reached its peak(0.545±0.041μg) at thefourteenth day; content of OHP of the wound in the two group at the3th,5th,7th,10th,14th day had significant difference (P<0.05).3Woundhistology examination: After injury, the third day, squamous cell andmost of the dermal tissue degeneration, necrosis, leukocyte infiltration, nosignificant difference in the two group; after injury, he seventh day, bothof the two groups of wound tissue showed necrotic tissue and leukocyteinfiltration, squamous epithelial cells, fibroblasts and capillary numberincreased, but in group A is obvious than in group B; after injury, thetenth day, squamous epithelial cells、fibroblast cells and capillary numberin group A were more than those in group B, collagen increasedobviously; after injury, the fourteenth day, in group A, fibroblasts, andcapillary number decreased, squamous epithelial cells and fiber cellscontinued to increase, while in group B, the fibroblasts, and capillary,squamous epithelial cells and fiber cells were increased, but less thanthose in group B; after injury, the seventeenth day，in group A, squamous cell arrangement was continuous, covered the entire wound,keratosis significantly, fibroblasts and capillary number decreasedobviously, in group B, fibroblasts and capillary number were more thanthose in group A, squamous cell cells, fibroblasts also increasedsignificantly, but squamous cell arrangement was not continuous.Conclusion: The experiments confirms that idea of moist therapy in thetreatment. The use of moist dressings, Hydrocoll to cover the wound inthe exudation period, Debridement period, can keep the wound moist, andthe surrounding normal skin tissue Non-impregnated, promotes necrosiscrusts dissolution, adsorbs necrotic tissue and secretions, to keep thewound clean and promote wound capillary growth and promote woundgranulation tissue growth and promote wound collagen synthesis, woundepithelial tissue growth and promote wound healing; The using ofTenderWet in wound epithelial formation period, continues to create amoist environment, promotes wound collagen synthesis, accelerateswound epithelialization, and promotes wound healing. Hydrocoll is softand flexible, good adhesion, With the size of wound the randomly cutHydrocoll, The use of savings. TenderWet and Hydrocoll incombination can promote rabbit deep II degree burn wound healing... |
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