VSD引流术在伴有严重软组织损伤的开放性骨折中的应用

The application of vacuum sealing drainage in the open limb fracture with serious soft tissue defect

目的探讨VSD引流术+一期固定治疗伴有严重软组织损伤的开放性骨折的临床疗效。方法采用VSD引流术+一期固定治疗24例伴有严重软组织损伤的开放性骨折(GustiloⅢ型)患者,创面面积8 cm×6cm^25 cm×20 cm,均为重度污染。结果患者伤口均完全愈合,无伤口感染,伤口裂开等并发症。24例均获得随访,时间8~12个月。骨折均获得骨性愈合,临床愈合时间10~24周。无固定失效,骨不连等并发症。结论 VSD引流术+一期固定术治疗伴有严重软组织损伤的开放性骨折,具有引流充分,感染率低,肉芽组织生长快的特点,能有效解决骨折固定和感染之间的矛盾,是一种简单,经济、有效的方法。

Objective To explore the effect of vacuum sealing drainage and primary fixation in the management of limbs open fracture and with serious and dirty skin an soft tissue defect.Methods 24 cases with Gustilo Ⅲ limbs open fractures and serious soft tissue defects were treated by vacuum sealing drainage and emergency internal fixation after debridement.The wound area were 8 cm×6 cm～25 cm×20 cm,all with serious contamination.Results The incisions of 24 cases healed.No incision infection,dehiscence or other complication was found.All cases were followed up for 8~12 months.All fractures got bony healing within 10~24 weeks.No fixation failure or nonunion were found.Conclusions The limbs fracture with serious and dirty soft tissue defects treated by vaccum sealing drainage and emergency internal fixation have advantages as complete drainage,low rate infection and good granulation,which can solve the contradiction of fracture fixation and infection,is a simple and effective,economical method.