224例胫腓骨开放性骨折伤口处理的体会

ANALYSIS OF TREATMENT OF WOUND IN 224 PATIENTS WITH OPEN FRACTURE OF TIBIA AND FIBULA

自1981年1月至1991年7月本科共收治了224例胫腓骨开放性骨折,199处伤口一期闭合(88.4%),25处为延期或三期闭合(11.6%)。伤口愈合较满意,总的感染率为9.40%,深部感染率为6.21%。现分析如下。

It is still a diffcult problem the fracture of tibia and fibula (OFTF) should be closed. During the period 1981--1991, a consecutive series of 224 patients with OFTF were treat- ed in the Department of Orthopedics, Nanfang Hospital. Of these patients there were 103 cases of type Ⅰ and Ⅱ fracture-and open 121 cases of type Ⅲ The wound was primarly suture in 100 (88.4%) and delayed the sut- ure in 2?(11.6%). The rate of the first int- ention of the wounds was 84.0% and the fu- netion of the extremities was reestabolished pretty good in most of the patients.The total infection rate of the wound was 9.4% and the deep infection rate 6.2%. We think that repeted irrigation of wound, keeping stabiliz- atinn of the injured extremity, strict avoidan- ce of closing the wound under tension by dif- ferent ways, vaccum suction, prompt and vig- orous antibiotic therapy, and delayed closure of wound if necessary are important measure- ments for control ling skin necrosis and the infection of wounds.