摘要
目的探讨改良封闭负压引流(vaccum sea ling dra inage,V SD)结合外固定器治疗伴有大面积软组织坏死缺损、骨关节外露和并发严重感染的开放性骨折的临床疗效。方法回顾性分析我院2007年1月至2010年12月41例下肢开放性骨折中大面积软组织缺损、骨关节外露并严重感染的患者,其中男性30例,女性11例;年龄12～69岁,平均40.1岁。先后行清创固定、换药、使用改良V SD和植皮及外固定器固定等治疗。结果 41例获3～12个月随访,平均6个月,40例伤口感染控制、伤口愈合、骨折愈合,1例形成慢性骨髓炎,再经抗生素等治疗后治愈。结论改良封闭负压引流术结合外固定器治疗开放性骨折中大面积软组织缺损、骨关节外露并严重感染,能有效控制感染,促进肉芽组织生长,早期行植皮闭合创面,骨折复位固定,缩短疗程,降低经济成本,减轻患者疼痛及减少医生工作量。
Objective To discuss the clinical application and results of improved vacuum sealing drainage（VSD） in large-area soft tissue damage and open fractures with severity infections.Methods This study examined retrospectively the 41 patients suffering from open fractures in lower limbs with large-area soft tissue damage,bone and joint exposure and Severity infections from January 2007 to December 2010.All patients received the effective therapy with improved VSD and external fixator to finish skin grafting,skin flap transplantation,reduction and fixation of fractures.Of 41 patients,30 were male,11 were female and the mean age was 40.1years（range,12 to 69）.Results 41 cases were followed up for 3~12 months,and the average followed up period was six months.40 patients had favorable outcome with severity infection,wound and fracture healing in the follow-up period.One patient had chronic osteomyelitis,which went to healing after the application of antibiotics.Conclusion The clinical application of improved VSD and external fixator in large-area soft tissue damage,bone and joint exposure and severity infections was of great efficacy to control the infections,enhancing the growth of granulation tissue,early skin flap transplantation,reduction and fixation of fractures.Moreover,this improved therapy could shorten the course of treatment,reduce the cost,and relieve the patients′ discomfort and even decrease the orthopedists′ workload.
出处
《实用骨科杂志》
2011年第11期994-997,共4页
Journal of Practical Orthopaedics
关键词
开放性骨折
改良封闭负压引流.外固定器
软组织缺损
感染
open fracture； improved vacuum sealing drainage； external fixator； soft tissue damage； infection
