颌面部破片复合冲击伤后软组织损伤特点及其临床意义

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目的 探讨颌面部破片复合冲击伤 (破 -冲伤 )后软组织损伤特点及其临床意义。方法  15只犬按伤后 0 ,6,2 4 ,72h、7d随机分为 5组 ,每组 3只。采用雷管、滑膛枪以及同步测速及测压系统 ,建立颌面部爆炸伤模型 ,造成犬颌面部破 -冲伤。记录致伤参数 ,观察动物伤情及局部距创缘不同距离的软组织伤后各时相点的病理变化。 结果  15只犬均呈左咬肌区软组织切线伤 ,创面污染严重 ,距伤区创缘 0~ 0 .8cm处肌组织完全坏死 ,0 .9~ 1.6cm处肌组织呈灶性坏死 ,正常组织与坏死组织相嵌存在 ;皮肤坏死范围距创缘 0 .2cm。 结论 颌面部破 -冲伤后软组织损伤范围广 ,污染严重 ,肌组织清创范围应距创缘 0 .9~ 1.6cm ,皮肤切除不小于 0 .2cm。 Objective To investigate the characteristics and clinical significance of soft tissue injury after maxillofacial fragment combined impact injury (TBI). Methods Fifteen dogs were randomly divided into 5 groups at 0, 6, 24, 72 and 7 days after injury. Using detonator, muskets and synchronous speed and pressure measurement system, the establishment of maxillofacial explosive injury model, resulting in canine maxillofacial injury - Chong injury. Injury parameters were recorded to observe the pathological changes of animal injury and local soft tissue injury at different time points. Results All the 15 dogs showed tangential wounds of soft tissue in the left masseter muscle area, and the wounds were seriously polluted. The muscle tissues were completely necrotic at 0 ~ 0.8cm away from the wound edge and focal necrosis was found at 0-9 ~ 1.6cm. The normal tissues Embedded in necrotic tissue; range of skin necrosis from wound edge 0.2cm. Conclusion Maxillofacial fractures - a wide range of soft tissue injury after injury, serious pollution, muscle debridement range should be from the edge of 0. .9 ~ 1.6cm, skin resection is not less than 0.2cm.
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