摘要
目的：分析外固定架结合负压封闭引流（VSD）治疗GustiloⅢB型胫腓骨开放性骨折的临床疗效。方法：选择2009年1月—2012年12月收治的GustiloⅢB型胫腓骨开放性骨折患者34例，分为两组。研究组18例，使用外固定架结合负压封闭引流治疗，均急诊给予彻底清创，复位骨折端，外固定架固定后行负压封闭引流，7～10d后拆除VSD，视情况给予更换VSD或植皮、皮瓣转移修复皮肤缺损及骨外露区。对照组16例，给予急诊清创外固定架固定术治疗，术后给予常规换药，视情况行植皮或皮瓣转移修复皮肤缺损及骨外露区。结果：研究组随访6～12个月，17例创面愈合，愈合时间为（19．3±5．2）d，1例发生骨髓炎。对照组随访7～13个月，13例创面愈合，愈合时间为（35．8±6．9）d，3例发生骨髓炎。结论：外固定架结合负压封闭引流治疗GustiloⅢB型胫腓骨开放性骨折操作简单，可有效处理软组织缺损，明显缩短创面修复时间，减少并发症，提高治疗效果。
Objective：To review the clinical efficacy of the treatment of Gustilo grade ⅢB tibia and fibula fractures by external fixator combined with vacuum sealing drainage. Methods：From January in 2009 to December in 2012,18 cases of study group were treated with debridement, external fixation and VSD covered the wound, then were treated with skin graft or pedicle flap graft according to the patients condition; 16 cases of control group were treated with debridement, external fixation,thenwere treated with wound dressing change. Results：Eighteen cases of study group were followed up for 6 ~ 12 months, 17 cases wound healed well, the average healing time was （ 19.3 ± 5.2） days, one case occurred osteomyelitis. 16 cases of control group were followed up for 7 -13 months, 13 cases wound healed well, the average healing time was （35.8 ± 6.9） days,3 cases oc- curred osteomyelitis. Conclusion ：The treatment of external fixator combined with vacuum sealing drainage for Gustilo grade Ⅲ B fractures of tibia and fibula is simple to operate,can efficiently handle the soft tissue defects, apparently shorten the treating time, reduce complications and enhance the treatment effect.
出处
《临床医药实践》
2014年第5期389-391,共3页
Proceeding of Clinical Medicine
