Distribution of Bacterial Contamination in Partial Penetration Surrogate Ballistic Wounds

Michelle R. Frybarger, K. H. Muci-Küchler
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Abstract

With the rise in use of IEDs during armed conflicts, there has been an increase in the number of injuries to the extremities. Shrapnel and debris ejected during the explosion become high-speed projectiles capable of penetrating soft tissues, bringing bacterial contamination into the wound. If not properly treated, that contamination could lead to infection. Studies aimed at understanding the distribution of bacterial contamination along the permanent cavity could provide useful information to improve treatment protocols for these types of injuries. In this paper, a lower extremity surrogate model was used to investigate bacterial distribution in partial penetration ballistic wounds. The targets used were ballistic gelatin blocks that had an Escherichia coli-laden filter paper placed on their front face. Spherical projectiles were fired into the targets adjusting their speed to obtain three different partial penetration depths. After each shot, a gelatin strip containing the permanent cavity was extracted and segmented. The permanent cavity was removed from each segment, placed in a test tube with buffer solution, and heated in a water bath to melt the gelatin. Standard microbiology protocols were followed to determine the number of colony forming units (CFUs) in each segment. The bacteria distribution was represented by percent of total CFU in the permanent cavity versus segment number. In addition, bacterial contamination as a function of projectile penetration depth was explored. For the cases considered, most of the bacterial contamination occurred in the segments closer to the projectile entry point.
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部分穿透性替代弹道伤中细菌污染的分布
随着武装冲突期间使用简易爆炸装置的人数增加,四肢受伤的人数也有所增加。爆炸过程中喷射出的弹片和碎片成为高速弹丸,能够穿透软组织,将细菌污染带入伤口。如果处理不当,这种污染可能会导致感染。旨在了解细菌污染沿永久腔分布的研究可以为改进此类损伤的治疗方案提供有用的信息。本文采用下肢替代模型研究部分穿透性弹道伤中的细菌分布。使用的目标是弹道明胶块,在它们的正面放置了一张含有大肠杆菌的滤纸。球体弹丸通过调整弹丸速度来获得三种不同的局部侵彻深度。每次注射后,一个含有永久腔的明胶条被提取并分割。从每个节段中取出永久腔体,放入带有缓冲溶液的试管中,并在水浴中加热以熔化明胶。按照标准微生物学方案测定每段菌落形成单位(cfu)的数量。细菌分布由永久腔中总CFU的百分比与片段数表示。此外,还探讨了细菌污染随弹丸穿透深度的变化规律。在所考虑的情况下,大多数细菌污染发生在靠近弹丸入口点的部分。
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