The use of negative‐pressure wound therapy (NPWT) has displayed significant clinical benefits in the healing of infected wounds. However, the effects of NPWT on bacterial colonisation and infection of traumatic wounds has been controversial. The aim of this study is to evaluate the impact of NPWT treatment in rabbits with a contaminated full‐thickness wound on bacterial behaviour, including colony morphology, spatial distribution, fissional proliferation, and bacterial bioburden. Full‐thickness wounds were created on the back of rabbits, and were inoculated with bioluminescent Staphylococcus aureus. The wounds were treated with sterile gauze dressings and NPWT with continuous negative pressure (−125 mm Hg). Wound samples were harvested on days 0 (6 hours after bacterial inoculation), 2, 4, 6, and 8 at the centre of wound beds before irrigation. Scanning electron microscopy and transmission electron microscopy (TEM) analyses were performed to determine the characteristic bacteriology. Laser scanning confocal microscopy was performed to obtain bioluminescent images, which were used to observe spatial distribution of the GFP‐labelled S. aureus within the tissue and quantify the bacterial bioburden. NPWT resulted in sparse amounts of scattered bacteria on the wound surface or as sparsely spaced single colonies within the tissue. Wound bioburden on day 8 in the NPWT and gauze groups was 34.6 ± 5.5% and 141.9 ± 15.4% of the baseline values (N = 6), respectively (P < .0001). TEM showed a lack of S. aureus active fission within NPWT‐treated tissue. NPWT can impact S. aureus colony morphology and spatial distribution both on the surface and within wound tissue, and reduce S. aureus as early as 48 hours after therapy initiation. Additionally, NPWT inhibits bacterial fissional proliferation in microcolonies.
Background Calcaneal fractures are associated with numerous complications and a poor prognosis with significant long-term quality-of-life issues, regardless of treatment. Therefore, in-depth research into the underlying mechanism of calcaneal fracture is still of great interest, with the goal of improving treatment for patients suffering from this condition. This study aimed to investigate the relationship between the distribution of calcaneal fracture lines and their determinants, especially those related to the internal structure of the calcaneus. This goal was achieved by fracture maps created by copying and stacking fracture lines as viewed from six surfaces of the calcaneus. Methods A total of 210 consecutive patients with 226 calcaneal fractures were retrospectively analyzed. Fracture lines were copied from a reduced 3D calcaneal fracture model and stacked on calcaneal templates to generate fracture maps. The stacked images of six calcaneus surfaces were also converted into spectrograms with MATLAB to highlight the fracture frequency at specific locations. Results There were four concentrated bands of fracture lines and two fracture hot spots on the superior surface. Three dense bands of fractures were observed on the medial surface, and four fracture bands were observed lateral to the calcaneus. Vertical fracture lines dominated the anterior calcaneal fracture map. On the posterior surface, the fracture lines appeared to be centered superiorly. All fracture locations coincided with the interfaces between the trabecular groups. Conclusions The fracture maps showed fracture patterns and recurrent fracture zones on all calcaneal surfaces. The shape of the talus and calcaneus and the architecture within the calcaneus, especially the arrangement of the trabeculae, are essential factors for calcaneal fractures.
Background: For fresh thoracolumbar burst fracture, a new method which can not only promote the fracture healing, but also retain the movement segment, and restore the spinal movement function to the maximum extent is needed. The purpose of this study is to determine the performance of stabilization of a semi-rigid stabilization system combined with transpedicular intracorporeal bone grafting for thoracolumbar burst fractures.Methods Six thoracolumbar cadaver spines were used for testing. A controlled L2 burst fracture was created. The L1-3 motions were determined.Results In extension, flexion and lateral bending, the semi-rigid fixator stabilized the segment to a range of motion(ROM) and neutral zone(NZ) below the magnitude of the intact spine, but showed increased ROM and NZ of axial rotation (P < 0.05) compared with the intact spine.Conclusions Restoration of stability with the semi-rigid dynamic system combined with transpedicular intracorporeal bone grafting is possible in flexion, extension, right and left lateral bending for thoracolumbar burst fracture but for axial rotation.
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