外固定器加冲洗治疗伴大面积创面感染的骨折

External Fixator and Irrigation for Open Fracture with Extensively Infected Wound

我们从１９８３年４月～１９９３年４月治疗７４例合并大面积创面感染的开放性骨折，男４８例，女２６例，年龄４～５６岁，平均年龄３８．５岁。合并感染创面最小面积２６ｃｍ×１１ｃｍ，最大面积４９ｃｍ×１６ｃｍ，平均面积２３ｃｍ×２３．２８ｃｍ。创面合并绿脓杆菌感染２４例，气性坏疽感染１８例，金黄色葡萄球菌感染２２例，合并大肠杆菌感染１０例。其中１组２０例采用湿敷换药加石膏外固定；２组２８例采用牵引加冲洗疗法；３组２６例采用单侧沟槽式外固定器加冲洗疗法。其中第３组全部治愈，可早期活动关节及行走锻炼，住院时间短，除针眼感染外，无其他并发症，疗效优于１组和２组。

Seventy-four patients of open fracture complicated with extensive wound infection (OFWI) from April of 1983 to April of 1993 were treated; of which 48 patients were males and 26 females. The average age of the patients was 38.5 years (range, 4～56 years). The mean size of infected wound was 535cm 2 (range 286～784cm 2). Twenty-four were infected by pycocyaneus bacilla, 18 by aerogenes capsulatus bacilla, 22 by aureus staphylococci and 10 by colibacilla. Twenty patients were treated by wound-dressing and plaster cast (group Ⅰ), 28 by skeletal traction and irrigation (group Ⅱ), and 26 by an unilateral adjustable external fixator and irrigation therapy (group Ⅲ).In group lⅡ, all the wound healed well. The patients could do exercise and walk early, the hospital stay was shortened and no other complications were found but pintract infection. The results of group Ⅲ were more satifactory than those of group Ⅰ and Ⅱ.