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Chin J Traumatol ; 22(1): 1-11, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30850324


Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Abdome/cirurgia , Drenagem/métodos , Medicina Baseada em Evidências , Guias de Prática Clínica como Assunto , Sociedades Médicas/organização & administração , Infecção da Ferida Cirúrgica/prevenção & controle , Traumatologia/organização & administração , Vácuo , China , Humanos
Exp Ther Med ; 13(4): 1376-1380, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28413480


The aim of the present study was to analyze the mechanism by which nerve growth factor (NGF) promotes callus formation in mice with tibial fracture. NGF transgenic homozygotic mice and NGF wild homozygotic mice were selected to construct non-stabilized fracture model of tibia. The mice were sacrificed on days 7, 14 and 21, respectively, and each group had a sample with 8 mice at each point in time. X-ray radiography and safranin fast green were used to observe fracture healing and in situ hybridization was used to examine the NGF mRNA expression of tibia at each phase of fracture healing. Tartrate-resistant acid phosphatase (TRAP) staining of callus tissue and the expression level of TRAP mRNA were combined to observe osteoclast formation. COL2A1, a chondrocyte differentiation-related gene in callus, and the mRNA level of SOX9 were combined to observe chondrocyte differentiation. It was found that under X-ray radiography, the fracture of NGF transgenic homozygotic mice healed in advance (P<0.05). Cartilage and bone tissue were identified by safranin and fast green staining. The residual cartilage on the callus tissue of NGF transgenic homozygotic mice had decreased significantly (P<0.05). The NGF mRNA expression level in each phase of callus formation of NGF transgenic homozygotic mice was significantly higher than that of the wild group (P<0.05). The number of positive cells in NGF-TRAP staining at each time point after fracture and the NGF mRNA expression level was markedly higher than that of the wild group, and the expression levels of COL2A1 and SOX9 mRNA were distinctively higher than that of the wild group. In conclusion, NGF potentially improves the healing of tibial fracture by osteoclast formation. Additionally, an increase in the number of osteoblasts in the NGF transgenic homozygotic mice compared with the wild-type mice may be achieved by cartilage differentiation due to NGF increasing the COL2A1 and SOX9 mRNA expression levels.

Injury ; 43(4): 452-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21925658


OBJECTIVE: Traumatic lumbosacropelvic fracture-dislocation is a rare but potentially serious injury. Conventional methods like lumbosacral fixation used to treat such injuries often result in suboptimal outcome secondary to complications like pseudoarthroses, sagittal imbalance and hardware failure. In this study, we retrospectively analysed the clinical features and management for this trauma using lumbo-iliac fixation. METHODS: Eight patients (6 male, 2 female; 21-52 years old, mean: 38.4) with traumatic lumbosacropelvic fracture-dislocation were surgically managed by lumbo-iliac internal fixation after lumbosacral decompression. Patients were followed up for 24-40 months (mean: 31.6). American Spine Injury Association (ASIA) scores were measured before surgery and at the last follow-up, and statistically analysed. RESULTS: After surgery, all patients experienced improved sensory and motor performance. Six patients showed recovery of bowel and bladder functions. Immediately after lumbo-iliac fixation, all patients could turn in bed without assistance. Lumbosacral alignment was restored immediately after surgery and no dislocation was observed during follow-up. Radiography indicated excellent integration between the autograft and the vertebrae. After surgery, no patient experienced neurological deterioration. CONCLUSION: Our experience with these cases suggests that early surgical decompression and posterior lumbo-iliac internal fixation can effectively restore spinal alignment, stabilise the spine, and improve neurological symptoms for this complex trauma.

Fixação Interna de Fraturas/métodos , Ílio/cirurgia , Luxações Articulares/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Adulto , Descompressão Cirúrgica , Feminino , Humanos , Ílio/lesões , Vértebras Lombares/lesões , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Pelve/lesões , Pelve/cirurgia , Estudos Retrospectivos , Sacro/lesões , Sacro/cirurgia , Fraturas da Coluna Vertebral/complicações , Adulto Jovem
Zhonghua Wai Ke Za Zhi ; 47(24): 1892-5, 2009 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-20193410


OBJECTIVE: To study the characteristic and surgical treatment of traumatic lumbo-sacro-pelvic injuries. METHODS: A retrospective study was carried out on 8 cases with traumatic lumbo-sacro-pelvic injuries between August 2005 and February 2008, which included 6 male and 2 female, aged from 21 to 52 years with a mean age of 38.4 years. ISS scores were undertaken to evaluate the injury severity of the cases after admission. Measures were taken to treat the emergency that affected the patients' lives. After the patients' conditions were stable, lumbo-iliac fixation was performed to treat traumatic lumbo-sacro-pelvic injuries. Imaging examinations were made to observe the reduction of fracture after operation. Injury of nerve was evaluated with ASIA score, and ASIA scores of preoperation and the last follow-up were analyzed statistically with paired t test. RESULTS: The group was followed up for 9 to 25 months, averaging 16.9 months. Postoperative imaging examinations showed satisfied reduction of fracture. The preoperative ASIA sensory score and motor score were 35.8+/-5.3 and 31.9+/-6.4 respectively, while the sensory score and motor score were 51.8+/-13.8 and 38.2+/-7.5 at the last follow-up respectively. The sensory and motor functions were improved significantly after operation (P<0.01). The functions of urination and defecation of 6 cases were recovered for different degree after operation. In all of the cases, no aggravated injury of nerve occurred. CONCLUSIONS: Traumatic lumbo-sacro-pelvic injuries is a kind of severe injury of lumbo-sacro-pelvic region. It can be treated with lumbo-iliac internal fixation and fine clinical effect can be gained.

Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Região Lombossacral/lesões , Ossos Pélvicos/lesões , Adulto , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/cirurgia , Adulto Jovem
Zhonghua Wai Ke Za Zhi ; 46(11): 801-5, 2008 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-19035209


OBJECTIVE: To describe the satisfactory intra-iliac paths in Galveston fixation combined with adult human cadaver and radiology study. METHODS: Five adult cadavers with 10 hemisected pelvises were harvested. Parallelly to the Chiotic line, the bone every other 5 mm till the superior rim of the acetabulum (SRA) observing the morphologic characteristics of each cross-sections of the iliac columns was cut. Fifty consecutive and randomly selected patients were measured using three-dimensional computed tomographic reformations. Three paths' valid bony canal lengths (LVBC), contractions' inner widths and positions were evaluated. RESULTS: The Path A with the longest LVBC (137 +/- 8) mm in male, (130 +/- 11) mm in female was the most satisfactory intra-iliac path according to both adult cadaver and radiographic measurement Path A and B allowed placement of 100 mm and 8 mm implants in male, 80 mm and 6 to 7 mm implants in female patients. CONCLUSION: The Path A, passing from the Click point towards the bottom of the anterior inferior iliac spine provides a longer and potentially safer anchor site compared with the traditional path.

Fixação Interna de Fraturas/métodos , Ílio/anatomia & histologia , Adulto , Parafusos Ósseos , Feminino , Humanos , Ílio/diagnóstico por imagem , Ílio/cirurgia , Masculino , Radiografia