Effects Of VSD On Postoperative Inflammatory Mediators And Vascular Endothelial Growth Factor In Patients With High Perianal Abscess

Objective: High perianal abscess due to its deep abscess,large wound postoperative and slow recovery,is considered anorectal disease difficult.Vacuum sealing drainage(VSD)technology because of its unique sustained negative pressure attraction principle,suitable for a variety of refractory wounds,has been in the field of surgical related to a large number of applications and widely recognized.This study is intended to investigate the effect of VSD on inflammation mediators and vascular endothelial growth factor(VEGF)in patients with high perianal abscess.Methods: A total of 38 patients by prospective collection with high perianal abscess who were treated with anorectal surgery from March 2015 to February 2016 were randomly divided into two groups according to the random number table: 19 patients in test group were execute by internal closure + VSD technique,and 19 patients in control group were execute by low incision combined with high thread operation.The levels of IL-6,TNF-?,hs-CRP,IL-4 and IL-10 were detected before surgery and after operation for 1 day and 5 days.The levels of vascular endothelial growth factor(VEGF)were measured before operation and after operation for 1 day,5 days and 7 days.The above test indicators were compared between groups and Compared intra-group.Results:1.Comparison of preoperative and postoperative pro-inflammatory mediators in both groups Before operation,1 days after operation,and after operation for 5 days,the contents of pro-inflammatory mediators(IL-6,TNF-?,hs-CRP)in the two groups were increased firstly and then decreased.Preoperative and 1 days after operation,two groups of patients with comparison of the content of IL-6,TNF-?,hs-CRP between groups,P > 0.05,the difference was not statistically significant..5 days after the operation,the IL-6,TNFand hs-CRP contents in the experimental group were lower than those in the control group,P<0.05,the difference was statistically significant.2.Compared intra-group of proinflammatory mediators content in test group The levels of IL-6,TNF-? and hs-CRP in test group One day after surgery were higher than those before operation,P<0.05,The difference was statistically significant.The levels of IL-6,TNF-? and hs-CRP in 5 days after operation were lower than those at 1 day after operation,P<0.05,The difference was statistically significant.3.Comparison of preoperative and postoperative anti-inflammatory cytokines in both groups Before operation,1 days after operation,and after operation for 5 days,the contents of anti-inflammatory cytokines(IL-4,IL-10)in the two groups were decreased firstly and then increased.Preoperative and postoperative 1 day,two groups of patients with comparison of the content of IL-4,IL-10 between groups,P > 0.05,the difference was not statistically significant..5 days after the operation,the IL-4,IL-10 contents in the experimental group were higher than those in the control group,P<0.05,the difference was statistically significant.4.Compared intra-group of anti-inflammatory cytokines content in test group The levels of IL-4,IL-10 in test group One day after surgery were lower than those before operation,P<0.05,The difference was statistically significant.The levels of IL-4,IL-10 in 5 days after operation were higher than those at 1 day after operation,P<0.05,The difference was statistically significant.5.Comparison of preoperative and postoperative VEGF in both groups Before operation,3 days after operation,5 days after operation,and after operation for 7 days,Two groups of patients with vascular endothelial growth factor(VEGF)protein content showed increased firstly and then decreased,and reached the peak on the 5 day after surgery.There was no significant difference between the two groups in preoperative VEGF content between the two groups.3 days after operation,5 days after operation,and after operation for 7 days,the VEGF contents in the experimental group were higher than those in the control group,P<0.05,the difference was statistically significant.6.Compared intra-group of VEGF content in test group The levels of VEGF in test group 3 days after surgery were higher than those before operation,P<0.05,The difference was statistically significant.The levels of VEGF in test group 5 days after surgery were higher than those 3 days after surgery,P<0.05,The difference was statistically significant.The levels of VEGF in test group 7 days after operation were lower than those at 5 days after operation,P<0.05,The difference was statistically significant.Conclusion: Compared with low incision combined with high thread,closure of internal orifice +VSD technology can reduce inflammatory media and increase anti-inflammatory cytokines more significant in the perianal abscess,so that the body's inflammatory response tends to be gentle,inflammatory and anti-inflammatory mediators to reach a balance,the body toward the direction of inflammation subsided and favorable recovery.At the same time,closure of internal orifice +VSD technology can increase the expression of VEGF significantly,so as to promote angiogenesis and wound healing.Therefore,the application of VSD technology in the treatment of high perianal abscess is beneficial to the inflammatory mediators and angiogenesis.