皮瓣转移在胫骨骨折慢性骨髓炎并皮缺损治疗中的应用

The application of skin flap in the chronic tibial osteomyelitis associated with skin defects

目的:探讨皮瓣转移在胫骨骨折慢性骨髓炎并皮缺损治疗中的应用。方法:本院收治胫骨骨折慢性骨髓炎并皮缺损患者23例,均采用一期清创应用邻近皮瓣覆盖、滴注引流,感染控制半年后行切开植骨内固定治疗骨折。结果:第1次术后23例皮瓣均成活,供区愈合良好。骨折植骨内固定术后,经皮瓣切口处皮肤愈合良好。术后随访1年半,骨折均愈合,无骨髓炎复发情况。结论:皮瓣一期覆盖皮缺损并行滴注引流、二期切开植骨内固定,是治疗胫骨骨折慢性骨髓炎并皮缺损的较好方法。

Objective：To investigate the application of skin flap in the chronic tibial osteomyelitis associated with skin defects.Methods：Tibial fractures were treated with chronic osteomyelitis and 23 patients with skin defects were debrided with an application close to flap coverage,drip drainage,infection control half underwent bone grafting and internal fixation open fractures.Results：Of the 23 cases in our hospital,all skin flaps survived directly.No infection and ischemic necrosis happened.After internal fixation of bone fractures,the incision via the skin flap healed well.After a followed-up of one and a half years,all fractures got a bone union without a osteomyelitis recurrence.Conclusion：One-stage debridment,local flap coverage and persistent wound perfusion associated with secondary bone grafting and internal fixation is an effective method for chronic tibial osteomyelitis associated with skin defects