联合应用负压封闭引流技术和腓肠肌肌皮瓣延期修复胫骨GustiloⅢB骨折的探讨

Delaying repair of Gustilo Ⅲ B tibial fracture by vacuum-assisted closure drainage combined with the gastrocnemius flap graft

目的 探讨联合应用负压封闭引流技术和腓肠肌肌皮瓣延期修复GustiloⅢB骨折的治疗方法及效果。方法对8例胫骨GustiloⅢB骨折后未能I期修复的患者进行彻底扩创，取出骨折固定物，应用负压封闭引流技术覆盖创面12～15d，切取转移腓肠肌肌皮瓣修复胫前软组织缺损。结果8例创面完全愈合，其中1例出现窦道，经换药15d后愈合。所有皮瓣完全成活，术后功能恢复，可行走。结论联合应用负压封闭引流技术和腓肠肌肌皮瓣延期修复胫骨GustiloⅢB骨折可获得较好的临床效果，值得临床推广应用和借鉴。

Objective To explore the therapeutic method and effect of vacuum assisted closure drainage combined with the gastrocnemius flap graft for the repaiv of Gustilo Ⅲ B tibial fracture. Methods Eight pa- tients of Gustilo Ⅲ B tibial fracture who could not be repaired primarily were enlarged the wound, taken off the fixation and then vacuum-assisted closure drainage was used to cover it for 12 to 15 days. The gastrocnemius flaps were cut and transferred to repair soft tissue defects before the tibia. Results Eight patients were com- pletely healed except for one case with a sinus which healed after 15 days by change dressings. The flaps on 8 patients all survived with walking function recovery. Conclusion The clinical results of vacuum-assisted clo- sure drainage combined with gastrocnemius flap graft is preferable and worth popularizing.