ABSTRACT
Objective To investigate the promoting effect of local compression and fixation on the healing of anterior tibial flask-like wound after debridement and suture.Methods A retrospective case control study was conducted to analyze the clinical data of 57 patients with simple anterior tibial flask-like wound admitted to the Second Hospital of Shandong University from May 2017 to June 2018.There were 32 males and 25 females,aged 20-60 years [(41.4 ± 8.1) years].The length of wound ranged from 1 to 10 cm.All patients had only acute skin and soft tissue injury,without any fracture,large area skin defect,large area avulsion injury,or chronic diseases such as diabetes mellitus and lower limb vascular disease.The study group contained 37 patients who were treated with local pressure dressing and limb fixation after debridement and suture while the control group included 20 patients who were treated with simple dressing after debridement and suture.At 3,5,7,14,and 21 days after operation,the size of the wound,the type and quantity of exudate,the color of skin around the wound and the type of wound tissue were compared,and the healing time was recorded.Results All patients were followed up for 30-90 days [(52.2 ± 3.5) days].Three days after operation,there was no significant difference between the two groups (P ＞0.05).On the 5th day after operation,the scores of exudate amount,skin color surrounding wound and tissue types of the wound bed in the control group and the study group were (4.2 ± 0.7) points ∶ (3.3 ± 0.6) points,(3.5 ± 0.7) points ∶ (2.5 ± 0.6) points,(3.4 ± 0.6) points ∶(2.5 ± 0.5) points (P ＜ 0.05),but there was no significant difference between the two groups in the scores of the size of wound and the type of exudate (P ＞ 0.05).On the 7th day after operation,the scores of the size of wound,type of exudate,amount of exudate,skin color around the wound and the type of wound tissue in the control group and study group were (3.5 ± 0.5) points ∶ (2.5 ± 0.7) points,(3.4 ±0.7)points ∶ (2.4 ±0.5)points,(4.0±0.8)points ∶ (2.8 ±0.5)points,(3.4 ±0.5)points ∶ (1.3 ±0.5) points,(3.3 ± 0.5) points ∶ (2.1 ± 0.4) points (P ＜ 0.05).On the 14th day after operation,the scores of the scores of the size of wound,type of exudate,amount of exudate,skin color around the wound and the type of wound tissue in the control group and study group were (2.9 ± 0.6)points ∶ (1.2 ±0.7)points,(2.8 ±0.7)points ∶ 0 point,(3.3 ±0.7)points ∶ (1.0 ±0.0)points,(3.1 ±0.6)points ∶(1.1 ± 0.4) points,(3.0 ± 0.6) points ∶ (1.2 ± 0.5) points (P ＜ 0.05).Twenty-one days after operation,the scores of the scores of the size of wound,type of exudate,amount of exudate,skin color around the wound and the type of wound tissue in the control group and study group were (2.5 ±0.7)points ∶0 point,(2.5 ±0.5)points ∶ 0 point,(3.0 ±0.7)points ∶ (1.0 ±0.0)points,(2.6±0.7)points ∶ (1.1 ±0.3) points,(2.6 ± 1.1) points ∶ 0 point (P ＜ 0.05).The wound healing rate was 100％ in both groups.The wound healing time of the control group and the study group was (28.3 ± 6.7) days and (15.2 ± 0.9) days respectively (P ＜ 0.05).Conclusion For anterior tibial flask-like wound,local pressure bandaging and fixation after debridement and suture can significantly promote wound healing compared with conventional simple bandaging,with the advantages of better healing quality and shorter healing time.
ABSTRACT
Objective@#To investigate the promoting effect of local compression and fixation on the healing of anterior tibial flask-like wound after debridement and suture.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 57 patients with simple anterior tibial flask-like wound admitted to the Second Hospital of Shandong University from May 2017 to June 2018. There were 32 males and 25 females, aged 20-60 years [(41.4±8.1)years]. The length of wound ranged from 1 to 10 cm. All patients had only acute skin and soft tissue injury, without any fracture, large area skin defect, large area avulsion injury, or chronic diseases such as diabetes mellitus and lower limb vascular disease. The study group contained 37 patients who were treated with local pressure dressing and limb fixation after debridement and suture while the control group included 20 patients who were treated with simple dressing after debridement and suture. At 3, 5, 7, 14, and 21 days after operation, the size of the wound, the type and quantity of exudate, the color of skin around the wound and the type of wound tissue were compared, and the healing time was recorded.@*Results@#All patients were followed up for 30-90 days [(52.2±3.5) days]. Three days after operation, there was no significant difference between the two groups (P>0.05). On the 5th day after operation, the scores of exudate amount, skin color surrounding wound and tissue types of the wound bed in the control group and the study group were (4.2±0.7)points ∶(3.3±0.6)points, (3.5±0.7)points ∶ (2.5±0.6)points, (3.4±0.6)points ∶ (2.5±0.5)points (P<0.05), but there was no significant difference between the two groups in the scores of the size of wound and the type of exudate (P>0.05). On the 7th day after operation, the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (3.5±0.5)points ∶ (2.5±0.7)points, (3.4±0.7)points ∶ (2.4±0.5)points, (4.0±0.8)points ∶ (2.8±0.5)points, (3.4±0.5)points ∶ (1.3±0.5)points, (3.3±0.5)points ∶ (2.1±0.4)points (P<0.05). On the 14th day after operation, the scores of the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (2.9±0.6)points ∶ (1.2±0.7)points, (2.8±0.7)points ∶ 0 point, (3.3±0.7)points ∶ (1.0±0.0)points, (3.1±0.6)points ∶ (1.1±0.4)points, (3.0±0.6)points ∶ (1.2±0.5)points (P<0.05). Twenty-one days after operation, the scores of the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (2.5±0.7)points ∶ 0 point, (2.5±0.5)points ∶ 0 point, (3.0±0.7)points ∶ (1.0±0.0)points, (2.6±0.7)points ∶ (1.1±0.3)points, (2.6±1.1)points ∶ 0 point (P<0.05). The wound healing rate was 100% in both groups. The wound healing time of the control group and the study group was (28.3±6.7)days and (15.2±0.9)days respectively (P<0.05).@*Conclusion@#For anterior tibial flask-like wound, local pressure bandaging and fixation after debridement and suture can significantly promote wound healing compared with conventional simple bandaging, with the advantages of better healing quality and shorter healing time.
ABSTRACT
Objective@#To investigate the preparation of bioactive denatured acellular dermal matrix (DADM) from burn mice riched in mice bone marrow mesenchymal stem cells.@*Methods@#Twelve BALB/c mice were collected and 20% total body surface area scalds (hereinafter referred to as burns) with deep partial thickness were inflicted on the back skin of each mouse. After removing epidermis, the burned skin were collected and divided into Triton X-100 group and elhylene diamine tetraacetic acid (EDTA) group according to the random number table, with 15 samples in each group. Samples in Triton X-100 group and EDTA group were respectively placed in mixture of 2.5 g/L Triton X-100 and 2.5 g/L trypsin solution and mixture of 0.2 g/L EDTA and 2.5 g/L trypsin solution for sustained vibration and elution for 24 hours to make mice DADM. The general appearance of DADM was observed. The structure and arrangement of collagen fibers of DADM were observed by scanning electron microscope and tissue structure of DADM were observed by fluorescence microscope. Bone marrow mesenchymal stem cells (BMSCs) from mice were transplanted in mice DADM in the two groups with concentration of 2×105 cells per well to prepare bioactive mice DADM. After cultured for 3 days, tissue structure of bioactive mice DADM was observed by hematoxylin and eosin staining, distribution and number of BMSCs of bioactive mice DADM were observed by immunofluorescence staining. Proliferation of BMSCs of bioactive mice DADM after cultured for 2 h, 1 d, 3 d, and 5 d was detected by cell count kit-8. Data were processed with analysis of variance for repeated measurement and t test.@*Results@#(1) Mice DADM in the two groups were white in appearance with certain tenacity and elasticity. Mice DADM in the two groups maintained good three-dimensional porous network structure. Collagen fibers of mice DADM in EDTA group were with good continuity, and collagen fibers of mice DADM in Triton X-100 group were fractured in varying degrees. Mice DADM in the two groups were decellularized completely, and the collagen fibers were loose and arranged disorderly. The continuity of tissue structure of mice DADM in EDTA group was better than that of mice DADM in Triton X-100 group. (2) After cultured for 3 days, the BMSCs in bioactive mice DADM in the two groups were evenly distributed. The number of bioactive BMSCs in mice DADM in EDTA group was 37±7, which was significantly more than that of mice DADM in Triton X-100 group (25±8, t=0.128, P<0.05). The proliferation of bioactive BMSCs in mice DADM in Triton X-100 group and EDTA group was similar at 2 hours and on day 1 after cultured (t=1.292, 0.656, P>0.05). On 3, 5 days after cultured, the proliferation of bioactive BMSCs in mice DADM in EDTA group was significantly higher than that of mice DADM in Triton X-100 group (t=2.309, 14.128, P<0.05 or P<0.01).@*Conclusions@#Mice DADM prepared by decellularization of EDTA has better three-dimensional porous network structure and good continuity of collagen fiber. The BMSCs in bioactive DADM from burn mice prepared by transplanting BMSCs are evenly distributed with large quantity and strong proliferative capacity, which has the potential to be good autologous dermal substitute.