开放性骨折的创口闭合时机选择

Timing selection of wound closure in open fractures

目的通过对开放性骨折清创后创口分泌物的微生物培养结果,选择创口的闭合时机。方法对182例开放性骨折患者均进行急诊清创,清创后进行创口分泌物培养。如果培养结果阳性,则再次清创后进行分泌物培养,直到培养结果阴性后才闭合创口。结果 182例开放性骨折患者总的深部感染率为5.5%,其中GustiloⅡ型骨折深部感染率为3.3%,Ⅲ型骨折感染率为7.9%。结论与文献报道比较,该治疗方案深部感染率较低。

Objective To select the timing of wound closure according to the microbial culture results of wound secretion after debridement of open fracture. Methods 182 eases of open fracture underwent emergency debridement. After debridement, the wound secretion euhure was immediately performed, ff the initial culture results were positive, the secretion culture was conducted again after redebridement. Until obtaining the negative culture results,wound closure was performed. Results Among 182 cases of open fractures,the total deep infection rate was 5.5%. The deep infection rate was 3.3% in Gustilo Ⅱ fracture and 7.9% in Gustilo Ⅲ fracture. Conclusion Compared with the published literature reports,the deep infection rate of this treatment regimen is lower.