Zatvaranje strelne rane primenom fibrinskog lepka sa antibiotikom : eksperimentalna studija

Abstract

Introduction. Primary delayed suture (PDS) of gunshot wound is used in the next 4-7 days from primary surgery (PS). This period coincides with the fibroblastic phase of wound healing. Fibrin glue has been used as a matrix for the local dosed release of antibiotics. Objective. Create the preconditions for the gunshot wounds closing without complications by the application of fibrin glue with antibiotics (FGA) 24 hours after primary surgical treatment. Methods. Fourteen pigs were wounded in the gluteofemoral region by the rifle M70AB2. All of them were treated according to the principles of war surgery doctrine, but seven of them after PS were treated with FGA (cephtriaxon and clindamycin). Wound healing was followed from clinical, laboratory, microbiological, histopathological (Hp) and MSCT side. Results. From clinical and Hp aspect, after surgical treatment, in both groups were not found signs of additional necrosis and infection. Laboratory values WBC, Gr, PLT, ALT, AST, LDH, CRP, and CK, after initial jump caused by trauma, go to normal values by 4-7 days in both groups. After taking wound smear, in group treated with FGA in vitro was not registered significant growth of bactery colonies, unlike the group treated with standard technique. Histopatology confirmed that use of FGA stimulated synthesis of young collagen in wound. Conclusion. Wounds caused by automatic rifle M70AB2 (7,62 mm), treated with FGA after PS and closed 24 hours later with PDS, in further evolution did not lead to development of complications. That is an advantage compared to the standard technique, where wounds are closed within 4-7 days.