两种方式处理胫腓骨开放骨折创面的初期结果

Initial results of two techniques for treatment of wound secondary to open tibiofibular fractures

[目的]比较两种方式处理胫腓骨开放骨折创面的初期结果.[方法]回顾性分析2015年1月-2020年1月本院骨科收治的开放性胫腓骨106例患者的临床资料.其中,56例采用VSD治疗,50例采用常规创面换药治疗.比较两组初期临床与检验结果.[结果]两组均顺利完成二期手术,均未发生严重并发症.VSD组植皮间隔时间、植皮前换药次数、二次闭合创面手术时间、二次闭合创面术中失血量、二次术后创面愈合时间和住院时间均显著少于常规组(P<0.05).检验方面,与初次术前相比,出院时两组患者WBC、N%、ESR和TNF-α均显著下降(P<0.05).初次术前两组间各项血液检测指标的差异均无统计学意义(P>0.05),但是出院时,VSD组的上述指标均显著优于常规组,差异具有统计学意义(P<0.05).[结论]对胫腓骨开放性骨折创面采用VSD治疗具有简便、安全、高效的应用优势,有利于创面闭合.

[Objective]To compare the initial results of vacuum sealing drainage(VSD)versus conventional dressing change(DC)for the wound secondary to open tibiofibular fractures.[Methods]A retrospective study was conducted on a total of 106 patients who received surgical treatment for open tibiofibular fracture in our hospital from January 2015 to January 2020.Among them,56 patients were treated with VSD,and 50 patients were treated with conventional dressing change temporally after debridement and external fixation.The initial clinical and laboratory results were compared between the two groups.[Results]The two-stage operations were successfully completed in both groups without serious complications.The VSD group was significantly better than conventional group in term of interval for skin graft,times of dressing change before skin graft,operation time for secondary wound closure,blood loss during the second wound closure operation,wound healing time and hospital stay(P<0.05).In terms of blood tests,WBC,N%,ESR and TNF-ot were significantly decreased in both groups at the discharge compared with those before primary operation(P<0.05).Although there were no statistically significant differences in the blood test items between the two groups before the first operation(P>0.05),the VSD group was significantly better than the conventional group in abovementioned items at discharge(P<0.05).[Conclusion]The VSD has the advantages of simple,safe and efficient application for treatment of open wound secondary to tibiofibular fractures,and is beneficial to wound closure.