保留内固定物治愈骨科感染伤口的实验与临床

Laboratory and Clinical Observation of Deep Infection with Internal Fixtures

骨折内固定或放置假体术后深部感染是一种极为严重的并发症。传统观点认为,不除去异物则不易使伤口愈合。根据我们的动物实验和临床13例的探索,内固定物,包括已镶嵌结实的人工假体,甚至游离骨块植骨的术后感染,均不一定要取出。只要能使伤口内得到充分引流并保持在一个清洁的环境中,就能够使深部感染得以治愈,同时又保留了内置物体。将感染病灶彻底清除并放置带有数个侧孔的硅胶管,连续冲洗即可达到上述目的。

Traditional viewpoints considered that internal fixtures or prostheses used in the treatment of open fracture had a tendency to develop deep tissue infection and the wound would hardly heal up without removing the internal fixtures. The result based on our animal tests and clinical observarion in 13 cases showed that it was feasible to cure the deep infectious wound without removing the internal fixtures, prostheses and free allogeneic bone. Thorough debridement and continuous washing with silica gel tube is essential to maintain the infectious wound a clear environment, and thus contribute to the cure of the wound infection.