单边外固定架联合负压封闭引流治疗地震伤员胫腓骨下段开放性骨折伴感染6例
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摘要
目的探讨单边外固定架联合负压封闭引流装置治疗胫腓骨下段开放性骨折伴感染、骨外露的效果。方法6例胫腓骨下段开放性骨折伴感染、骨外露的伤员经清创、单边外固定架固定、负压封闭引流治疗后采用植皮或皮瓣转移等方法覆盖骨外露创面。结果本组6例伤员经综合治疗后,感染得以消除,骨外露面体积较小者被新鲜肉芽组织直接覆盖后行植皮或皮瓣转移,骨外露面较大者经骨面钻孔引导肉芽组织覆盖骨面后植皮,全部一次成活。结论采用单边外固定架联合负压封闭引流装置治疗胫腓骨下段开放性骨折伴感染、骨外露,在有效固定了骨折的同时,负压封闭引流封闭了创腔,控制了感染,并刺激大量的肉芽组织增生覆盖骨面为皮瓣转移或植皮提供了有利的条件,是临床上值得推荐的好方法。
Objective To evaluate the effect of external fixator device combined with (VSD) in the treatment of open tibia and fibula fracture following paragraph infection and bone exposure.Method Six patients of open tibia and fibula fracture with infection and bone exposure were given VSD treatment after debridement and unilateral external fixation,followed by skin graft or flap transfer to repair surface of wound.Result The infection of wound be eliminated,small wound of bone exposure was performed skin graft or flap transfer after fresh granulation tissue coverage,big wound of bone exposure was performed skin graft after bone drilling guided the granulation tissue coverage,the all wound of 6 patients recovered in one times.Conclusion Unilateral external fixator device combined with VSD is effective method in the treatment of open tibia and fibula fracture following paragraph infection and bone exposure.Effectively fixed the fracture at the same time,VSD closed the wound cavity and control of the infection,and a lot of granulation tissue hyperplasia coverage for bone exposure provide favorable conditions to skin graft or flap transfer.
Objective To evaluate the effect of external fixator device combined with (VSD) in the treatment of open tibia and fibula fracture following paragraph infection and bone exposure.Method Six patients of open tibia and fibula fracture with infection and bone exposure were given VSD treatment after debridement and unilateral external fixation,followed by skin graft or flap transfer to repair surface of wound.Result The infection of wound be eliminated,small wound of bone exposure was performed skin graft or flap transfer after fresh granulation tissue coverage,big wound of bone exposure was performed skin graft after bone drilling guided the granulation tissue coverage,the all wound of 6 patients recovered in one times.Conclusion Unilateral external fixator device combined with VSD is effective method in the treatment of open tibia and fibula fracture following paragraph infection and bone exposure.Effectively fixed the fracture at the same time,VSD closed the wound cavity and control of the infection,and a lot of granulation tissue hyperplasia coverage for bone exposure provide favorable conditions to skin graft or flap transfer.
引文
[1]Fleischmann W,Lang E,Kinzl L.Vacuumassisted wound closure after der-matofasciotomy of the lower extremity[J].Unfallchirurg,1996,99(4):283～287
[2]Coerper S,Wagner S,Witte M,et al.Temporary expression pattern in wound secretions and peripheral wound biopsies[J].Zentralbl Chir,1999,124(S):78～80
[3]DeFranzo AJ,Argenta LC,Marks MW,et al.The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone[J].Plast Reconstr Surg,2001,108(5):1184～1189
[2]Coerper S,Wagner S,Witte M,et al.Temporary expression pattern in wound secretions and peripheral wound biopsies[J].Zentralbl Chir,1999,124(S):78～80
[3]DeFranzo AJ,Argenta LC,Marks MW,et al.The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone[J].Plast Reconstr Surg,2001,108(5):1184～1189
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