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Research of Treating Blast Injury-induced Abdominal Wall Defects in Pigs with VSD

Author: ShaoJianChuan
Tutor: GuoShuZhong；HanYan；YiChengGang
School: Fourth Military Medical University
Course: Surgery
Keywords: animal model VSD blast injury abdominal wall defects
CLC: R82
Type: Master's thesis
Year: 2011
Downloads: 9
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Abstract

Background The number of exploded patients are drasticallyincreased in the modern wars. Despite advanced surgical techniques inmedical field managing combat-related injuries remain challenging within thewar theater. Compaired with the general weapon, the explosive weapon cancause not only bigger defects of abdominal wall with severe contamination,but also abdominal viscera exposure. The principle of military medicalmanagement for blast injury-induced abdominal wall defects is damagecontrol surgery which includes hemostasis, radical debridement, irrigation,temporary abdominal closure and delayed closure for wounds that are severelycontaminated. Several techniques are available for this temporary abdominalclosure. There are various of temporary abdominal closure materials andtechniques with advantages and disadvantages, and each one has its ownindications. It has been documented that VSD decreased the infection rate ofacute or chronic wounds. But if it is capable to decrease the bacteria load ininjury wound-induced abdominal wall defects, resist infection and irritation tothe serosa and underlying bowel, resist enterocutaneous fistula, and close abdomen earlier still remain unknown. To answer these questions, weestablished an animal model of injury wound-induced abdominal wall defectsin pigs and used VSD to treat the wounds. This subject studied the appliedworth of VSD in the repair of injury wound-induced abdominal wall defectsby animal experiment.Objective To establish an animal model of injury wound-inducedabdominal wall defects and explore the effects of vacuum sealingdrainage(VSD) for blast injury wound-induced abdominal wall defects in pigs.Methods Twenty small white domestic pigs models were markedinjured parts under general anesthesia conditions.All animals appliedself-made enterocoelia protective device then used 1.5g PENT explosivesstuck on the site of injury. After injury, we observed generally forms. Thebacteria clonies of wounds and intraabdominal fluid dultures were observed.Twenty small white domestic pigs models of exlposive abdominal woundswere divided into two groups. All wounds were debrided 6 hours after injury.Group A set the pressure at -125mmHg, VSD therapy was applied to the openabdomen by placing a fenestrated silicone sheeting over the abdominal viscera.Group B treated with silicone sheeting, which was covered with asalinesoaked gauze dressing that was changed several times daily. Duration oftreatment, days of preoperation, times of dressing, the ratio of soft tissueinfection and intraabdominal infection were compared between two groups.Results All animals with wound-induced abdominal wall defects werecaused by explosive,In VSD group, days of preoperation were (7.20±2.39)days,times of dressing were (2.20±0.79), the ratio of soft tissue infection was 10%,intraabdominal infection was 10%. In non-VSD group, days of preoperation were (10.30±2.11)days, times of dressing were (11.90±2.23), the ratio of softtissue infection was 70% intraabdominal infection was 70%. There weresignificant differences in the preoperative days, dressing times, the ratio of softtissue infection and intraabdominal infection between two groups(p<0.05).Conclusion This experiment simulated the mechanism of abdominalwall blast injury. The change of local soft tissue copy the special trauma of blastinjury. It is appropriate for research use.It is effective to apply VSD tomanagement blast injury would-induced abdominal wall defects, which canshorten the preoperative days, cut down infection rate, decrease times ofdressing.

Research of Treating Blast Injury-induced Abdominal Wall Defects in Pigs with VSD

Abstract

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