Primary Study on the Effects of Limbs Periosteum in Open Soft Tissue Injury with Seawater Immersion
|School||Anhui Medical University,|
|Keywords||Open injury Seawater immersion Periosteum Pathology Bone morphogenetic protein Vascular endothelial growth factor Tumor necrosis factor - alpha Transforming growth factor - beta1|
Background and Objective: In the naval battle and landing operations, limbs, open injury is the most common injury type, often accompanied by seawater immersion. The various maritime accidents, flight crashed at sea, diving operations, submarine escape and offshore drilling platform accident and other objective conditions, it is inevitable not to be subjected to seawater immersion, particularly the physically immersion wound. Seawater temperature is low, containing sodium chloride 0.53 to 0.58 mol / L (3l to 34 g / L), pH 8.0 to 8.21, is a hypertonic, strongly alkaline liquid with special physical and chemical properties, and contains nearly 20 kinds of human body a significant pathogenic role of bacteria. Open fractures combined with seawater immersion infection rate increased callus formation delay, poor callus formation, the healing process is delayed fracture healing strength was significantly lower than the control group. Periosteal osteogenesis and growth process plays an important role, the Osteogenesis function mainly lies in the cambium layer of the periosteum, with fracture healing of cells required. The subject from the point of view of animal experiments to study seawater immersion of open soft tissue injury to the periosteum of. The experimental rabbit limb soft tissue openness injury combined seawater immersion wound as experimental models, take the periosteum do histological observation and detection Limbs periosteum related cell factor expression case, explore the salt water soak on the long backbone of the periosteum and the occurrence of mechanisms, of seawater immersion of open injury clinical treatment to provide a theoretical basis. Research methods and content: rabbit hind limbs open soft tissue injury and seawater immersion wound animal model, experimental animals trauma at different times after the end of the observation intervention (0d, 1d, 3d, 7d) limbs periosteum pathological changes by HE staining compare seawater soak or periosteal changes, and the use of immunohistochemical staining method of observation and comparison of bone morphogenetic proteins (BMPs), vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1) in the difference of positive expression of the of traumatic limb periosteum and around. Results: (1) open injury of soft tissue composite seawater immersion periosteal inflammatory response after injury was more serious than a simple injury group, the longer soaking time, the heavier the periosteal inflammatory response. (2) 1, 3, 7 days after injury, group B germinal layer cell layers increased significantly, with group A and group C contrast very significant difference (P lt; 0.01); group A periosteal cambium layer cell layers compared with C group increased, but they showed no significant difference (P gt; 0.05) (3) seawater immersion 1h membrane bone significantly delayed, and soak for 30 minutes, the membrane bone did not slow down significantly. (4) C BMPs and VEGF periosteal bone cells and osteoblasts expressed time was significantly delayed and significantly weaker than in group B and group A, group B BMPs and VEGF expression time, although not delay but weaker than the A group. (5) TNF-alpha expression in the three groups periosteal osteogenic cells and osteoblasts, and reached a peak on the first postoperative day, then gradually decreased, the amount and timing of its expression extended with seawater immersion time. (6) TGF-beta1 in the three groups of cells and periosteal bone osteoblasts expression and sustained expression were observed from 0 to 7 days, wherein the B group was significantly stronger than the C group and the A group. Experiments Conclusion: open soft tissue injury combined after seawater immersion for 30 minutes, the membrane into the bone no significant delay, the periosteum bone cells and the proliferation of osteoblast differentiation not be significantly affected; after seawater immersion 1h, the membrane bone significantly delayed, periosteal bone cells, cell proliferation and osteogenic differentiation was significantly delayed. The seawater immersion increased periosteum damage, after seawater immersion 1h, can be significantly delayed and damage the periosteum membrane bone formation ability, prompted the periosteum of seawater immersion wound longest tolerance time may be less than one hour.