破溃兔扩张皮瓣的细菌学研究(1)
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[摘要]目的：研究扩张皮瓣破溃后不同时段及部位的细菌状态。方法：以新西兰大白兔作为实验动物。首先形成兔扩张皮瓣模型，进而形成破溃的扩张皮瓣模型，并随机分为A、B、C、D破溃时间长短不同的四组。各组的皮瓣组织均以破口为中心，呈环状由内向外分为6个部分；然后在无菌的环境下分别对这6个部分进行标本采集。采取的标本采用Cooney法进行细菌定量检查和常规接种、需氧和厌氧培养定性检查。结果：①随着破溃时间的延长，破口周围炎症反应的皮肤长度逐渐增大，皮瓣组织内的细菌数量逐渐增多；各组间有显著差异(P<0.05)；②破溃时间大于3周，皮瓣基底出现感染几率明显增大(17%vs 100%；P<0.05)，此时整个皮瓣组织都有细菌的存在；③皮瓣基底未感染时，细菌仅存在于破口周围炎症反应的皮肤包膜复合组织及其外0.5cm的范围内；④存在的细菌主要为革兰阳性菌。结论：扩张皮瓣破溃后，皮瓣各部的细菌状况会出现改变，临床上应予注意。
[关键词]扩张皮瓣；破溃；细菌学
[中图分类号]R332 [文献标识码]A [文章编号]1008-6455(2012)01-0058-03
The experimental study of the bacteriology of the recipient bed of the ruptured expanded flap
HU Shou-duo1,ZHAO Yan-yong2,JIANG Hai-yue2,YANG Qing-hua2,ZHUANG Hong-xing2
( 1.Plastic and Cosmetic Surgery Department of the Peking Hospital of Integrated Chinese with Western Medicine,Beijing 100039,China; 2. Plastic Surgery Hospital of Chinese Academy of Medical Sciences,Beijing 100114,China)
Abstract: Objective To study the bacteriology of the ruptured expanded flap. Methods The New Zealand White rabbits were selected as experimental animals. Firstly,the ruptured expanded flap animal models were made and were randomly classified into four groups, named as A group,B group, C group and D group. The tissues of the flap of each group were divided into six parts from center to edge when taking the rupture as the center. The specimens were taken from these parts. All the specimens were quantificationally examined with Cooney's method and qualitatively examined for gram smear and aerobic and anaerobic cultures. Results The experiment results revealed that: ①with the extension of the rupture time, the length of the inflammatory reaction skin-capsule composite tissue gradually increased,the bacterial number in the flap tissue increased. the significant differences existed between each group(P﹤0.05). ② If the rupture time lasted more than three weeks, the infectious ratio of the floor would increase significantly (17%vs67%;P﹤0.05). when the floor infection did exist, bacteria could be found in all parts of the flap. ③If the floor didn't infect,the bacteria exist within the scope 0 ......
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