一期内固定结合置管冲洗负压封闭引流技术在下肢Gustilo-Anderson Ⅲ型开放性骨折治疗中的应用

Clinical application of primary internal fixation combined with irrigation and vacuum sealing drainage for Gustilo-Anderson Ⅲ open fractures of lower limb

目的:探讨一期内固定结合置管冲洗负压封闭引流治疗下肢开放性骨折的临床效果。方法:对2008年5月-2010年5月我院收治的27例下肢开放性骨折患者行一期清创,骨折采用髓内钉或锁定接骨板内固定,伤口内置管冲洗,创面用VSD材料封闭,持续负压引流的方法进行治疗。结果:27例患者中19例术后创面获得一期愈合,8例患者行二期植皮或皮瓣修复获得愈合,25例患者获得随访,通过6～18个月的随访,23例患者如期愈合,2例延迟愈合,无一例发生骨髓炎。结论:结合置管冲洗负压封闭引流技术,下肢开放性骨折可以采用一期内固定缩短治疗周期,减轻患者痛苦。

Objective：To investigate the clinical effect of primary internal fixation combined with irrigation and vacuum sealing drainage for Gustilo-Anderson Ⅲ open fractures of lower limb.Method：From May 2008 to May 2010,27 patients with open fractures of lower limb were treated in our hospital.After the debridement,fractures was reduced and fixed by interlocking intramedullary nail or LCP.Irrigation tube was placed for irrigation,and then the wound area was covered with the VSD system.Result：Primary healing of the wounds was achieved in 19 cases.8 cases were cured by two stages of split skin graft or flap.25 cases were followed up for 6 to18 months.23 of the 25 cases had bone union in primary stage,and the other 2 cases were achieved delayed union.No osteomyelitis was noted.Conclusion：Primary internal fixation combined with irrigation and vacuum sealing drainage is a safe and reliable operation for Gustilo-Anderson Ⅲ open fractures of lower limb.It can not only shorten the healing time,but also alleviate the pain in patients.