| The number of exploded patient drastically increases in modern war. Compaired with the general weapon, the explosive weapon can cause not only bigger defects of soft tissue with severe contamination, but also bone defects or bone exposure in limb injury. At present, it's difficulty to treat such wound, but the advanced technology of plastic surgery and the exploiture of new bone graft substitute provide the chance for ealy healing of wound. We carried out a series of study on the optimum method and time closing explosive wound with tissue defects and the application of G-BRX to explosive bone defects.Myocutaneous flap, having abundant circulation and strong anti-infectious ability, is widely applied to open fracture or infective wound which isn't blasted, especially, when local flap can't applied in the severe trauma, the free myocutaneous flap show drastically advantage. The study discussed the applied possibility and early optimum time of free myocutaneous flap transplantation on explosivewound.G-RBX with the peculiarities of Inducing osteogenesis and preventing infection shows advanced function of osteogenese and ability of anti-infection in animal experiment and clinic practice. When it was applied to repair contaminative and infectious bone defect in primary time, it obviously decreased the morbidity of osteomyelitis and shortened the time of treatment that needed two operations in according to traditional management. This subject studied the applied worth of G-RBX in the repair of explosive bone defects by animal experiment.1. A shock wave model of explosive injury to limb in dog [Abstract] Objective To found a animal model of explosive trauma to limb, and to study the characteristics of wound and the damage degree and extension of circumference tissue of limb explored with a shock wave. To provide the basic data to the fallowing study. Methods To explode the limb of dog with a equipment composed of directional part and quantitative part and crural controlling part in the distance of lcm, 2cm, 3 cm and 4cm respectively. Subsequently, to observe the local tissue change characteristics by general specimen and pathology. Results To obtain diversity limb model of explosive injury by adjusting the equipment. The soft tissue of wound circumference has a continuous change in 3 cm, the more nearer distance to the wound, the more severe trauma to the soft tissue. Conclusion the equipment can provide diverse model of limb trauma for different experimental objective, the change of local soft and bone copy the special trauma of shock wave. The range of primary debridement should extend to 2cm by skin and 1 cm by muscle. 2. The evaluation of antibacterial ability and bone formationalability of free myocutaneous on type IIIb fracture of limbObjective An experienmental model was designed to evaluate the ability of the muscular flap preventing infection and promoting the bone formation in hare. Methods 40 hares were divided into four groups (A, B, C, D).The Quadriceps femoris muscle was excised to expose the anterior femur, and a 15x4mm2 segment of devascularized bone was havested . In group A and B, the segments were dipped in 0.2ml solution that contain 5x105CPU of bacterias, and in group C and D, they were dipped in 0.2ml solution without bacterias. After a half hour, they were returned to their original position. The rectus abodominis muscle flap based on inferior epigastric artery (group A, C) or the epigastric skin flap based on superficial artery was elevated (group B, D) and covered the wound of thigh. Both flap were managed to simulating free flap with a series method in advance. After four weeks, comparing group A with group B in the change of leucocyte from blood and bacteria quantity from segment of devascularize bone, to evaluate the ability of the muscular flap preventing infection. Comparing group C with group D in the radiation of the segment of devascularize bone, to evaluate the ability of the muscular flap promoting the bone formation. Results comparing group A with group B... |
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