中药外治结合外科手术治疗胫骨创伤后骨髓炎骨质皮肤缺损

Chinese herbs application combined with operation for treating post-traumatic tibial osteomyelitis complicated with bone-skin defects

目的:探讨中药外治结合外科手术治疗胫骨创伤后骨髓炎骨质皮肤缺损的方法和疗效。方法:本组胫骨创伤后骨髓炎骨质皮肤缺损28例,男18例,女10例;年龄18～68岁,平均32.5岁。采取外用中药换药,待创面感染控制后取带血管髂骨皮瓣移植Ⅰ期修复,随访治疗效果并进行分析。结果:28例均获随访,时间8～56个月,平均30个月。皮瓣全部成活,伤口Ⅰ期愈合26例,Ⅱ期愈合2例。移植骨全部愈合,愈合时间2～14个月,平均4.6个月。骨髓炎复发2例,经二次病灶清除愈合。结论:外用中药换药结合外科手术治疗胫骨创伤后骨髓炎骨质皮肤缺损,能够有效控制感染,一次性修复组织缺损,值得临床推广。

Objective ：The aim of this study was to explore the method and clinical effects of integration of Chinese herbs and operation for the treatment of post-traumatic tibial osteomyelitis complication with bone-skin defect. Methods：Among 28 patients with post-traumatic tibial osteomyelitis complicated with bone-skin defects, 18 patients were male and 10 females, ranging in age from 18 to 68 years,with an average of 32.5 years. All the patients were treated with transplantation of free iliac flaps to one-stage repair the bone-skin defects after infection controlled with Chinese herbs dressing. The curative effects were analyzed. Results ： All the patients were followed up and ranged from 8 to 56 months, with an average of 30 months. All of the flap survived ,and the wounds got primary healing in 26 patients and secondary healing in 2 patients. All the grafted bone united in 2 to 14 months, with a mean time of 4.6 months. The osteomyelitis recurred in 2 patients and got healed by focal debridement. Conclusion：Chinese herbs application combined with operation for treating post-traumatic tibial osteomyelitis complicated with bone-skin defects is effective to control infection, one-stage repair the tissue defects, which is worthy popularizing.