| Objectives: To make up an irrigating machine for firearm wound so as to improve the successful rate of immediate treatment and reduce the infection rate of firearm wound.Methods: The machine is made of pump, pressure adjuster, heater, nozzle, shield, and so on. All parts are nontoxic. We tested its capability and efficiency by animal experiment.Twelve mongrel dogs were divided into three groups: computer irrigating machine group (CIM), rubber ball group (RB), pouring bottle group (BP). Every group has 8 hind limbs of 4 dogs. The wounds were rinsed 6h after shooting. Jetting flow was 30~45?to inside surface of wound tract and l~2cm above in CIM and RB. Irrigating pressure was 0.35kg to 0.56kg every square centimeter in CIM and bring by pressing the ball in RB. Irrigating solution (500ml, normal saline) was conducted from top to down inside every wound. The solution was kept at 35癈. The manner, heart rate, respiration, temperature, gross tissue change, heal tune, drainage volume, quantity change of bacteria, optical microscope examination in wound tract were surveyed and measured.Results: A machine was made up successfully. Various working lights were fitted on the outside surface of it to tell the machine's working state. When the electrical button was turn-on and the pressure, temperature, irrigating manner were choose, the machine would start to work. What the machine has superior to others is that it is able to insist the pressureinvariableness, and pulse, shield and temperature can be adjusted.Our study told that:(l) There were changes of T, HR, and R in three groups during the experiment. The CIM group raised slowly and have significant difference with other groups(P < 0.05, P < 0.01), but other two groups had no difference (P > 0.05). (2) The putrescence fragments, blood clots were washed down in CIM, there were a few in RB, and a lot in BP after immediate irrigation. 7 days after, one wound was infected in CIM, two in RB, and three in BP. (3) The heal time of CIM group was shorter than the other groups (P < 0.05, P < 0.01), and the difference is significant, but there was no difference between the other two groups (P > 0.05). (4) There were decreases of bacteriological quantitative in deep tissue and on the surface after irrigation in three groups. But the changes of CIM group wad significant different to the other groups (P < 0.05,P < 0.01), and there was no significant difference between the other two groups(P > 0.05). (5) The drain of CIM group was significant different to the other groups in 4 days after irrigation(P < 0.05, P < 0.01). Drainage volumes ascend at 5th, 6th in CIM, and 3rd, 4th in RB and BP. (6) Pathological morphology: The vascular permeability, and tissue swell of CIM group was slighter than the other groups in 6h after irrigation. The necrosis tissue was mixed by normal tissue; 3d after irrigation, the speed of repair of CIM was faster than the other groups. In CIM, blood capillary began to form from the edge of wound. Fibroblast covered the wound and joined it. However, in the other groups, inflammatory reaction remains active, and there still were lots of degeneration and necrosis cells.Conclusions: The machine is excellent in capability and efficiency. It was declared patent of practicality new type, its application number is 03223855.X. It has these merits: (1) Postpone body's physiological reflection effectively, such as the change of T,. HR, R is obviously smaller than RB, BP. Accelerate the improvement and recovery of physiology, and reduce the appearance of complication. (2) Obviously reduced the infiltration of inflammation cell and the permeability of vessel in wound, and reduceddrainage of wound, so prevent the pathological change of wound tissue. (3) Clean out bacteria, necrotic tissue and blood clot, so as to shorten heal time and decreased infection rate. (4) Produce pulse in order to make the tissue shrink and stretch in difference phases. Then the foreign material and bacteria lurked in deep tissue became less crowded and swept. The pressure... |
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