OBJECTIVETo explore the therapeutic effect of debridement and vacuum sealing drainage (VSD) of cavitas medullaris for the treatment of chronic osteomyelitis of tibia.

METHODSFrom March 2006 to May 2009, 19 patients with chronic osteomyelitis of tibia were treated by debridment and VSD, then the second operation were performed to close the wound. Among them, 12 patients were male and 7 patients were female, the average age was 39 years (ranged from 25 to 68 years). The course of disease were from 10 months to 5 years. The main clinical symptoms were red swelling, tenderness and fluid of local soft tissue. There were prolonged unhealed sinus and pus; the X-ray showed osteosclerosis, increased bone mineral, and sequestrum and dead space was formed. The result of bacterial culture showed 3 cases were aeruginosus bacillus, 13 cases staphylococcus aureus, 1 case bacillus aerogenes and 2 cases beta streptococcus. Among them, 3 cases were methicillin resistant staphylococcus (MRS).

RESULTSAfter debridement and VSD of cavitas medullaris 18-22 days later, the granulation tissue grow well and the wounds of the 19 patients all healed primarily with direct suturing of 17 cases, loco-regional flap of 2 cases. The standard of wound healing was the dryness, cleanness and no drainage. The X-ray revealed the bone tissue grew well and no relapse and fracture occurred during followed-up 6-12 months.

CONCLUSIONThe debridement and VSD of cavitas medullaris is a very effective and safe treatment for chronic osteomyelitis of tibia.