Application of external fixator combined with vacuum sealing drainage for limbs’ open fracture with severe soft tissue injuries
10.3969/j.issn.2095-4344.2014.44.019
- VernacularTitle:外固定架结合泡沫敷料覆盖负压引流修复软组织严重损伤的四肢开放性骨折
- Author:
Shenpeng LIU
;
Guang WAN
;
Qiudong LIANG
;
Yongzhuang DUAN
;
Haibin XU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2014;(44):7157-7161
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:The treatment of limbs’ open fracture with severe soft tissue injury is very complicated. There are many wound exudates, high frequency of dressing change, and high infection rate. How to deal with the contradiction between wound treatment and fracture fixation is the considerable problem in clinical therapy. ＜br> OBJECTIVE:To explore the effect of external fixator combined with vacuum sealing drainage on limbs’ open fracture with severe soft tissue injuries. ＜br> METHODS:A total of 34 patients with limbs’ open fracture with severe soft tissue injuries were enrol ed in the First Affiliated Hospital, Xinxiang Medical Col ege from December 2009 to December 2010. There were 20 males and 14 females, with an average age of 36.6 years old. There were 10 cases of upper limb fracture and 24 cases of lower limb fracture. After debridement, cutaneous deficiency accounted for 1%to 6%of surface area. On the basis of external fixation, the wound received vacuum sealing drainage (treatment group;n=17) and conventional dressing (control group;n=17). According to limb swel ing and granulation growth, delayed suture, skin graft or flap to cover the wound were used. After treatment, infection rate of the wound and growth of granulation were observed. In accordance with wound healing and growth of granulation, curative effects were evaluated. ＜br> RESULTS AND CONCLUSION:In the treatment group, there were 11 cases of healing, 5 cases of effective effects, and 1 case of ineffective effect, with a total effective rate of 94%and the infection rate of about 15%. In the control group, there were 7 cases of healing, 6 cases of effective effects, and 4 cases of ineffective effects, with a total effective rate of 76%and the infection rate of about 40%. Significant differences in healing rate, total effective rate and infection rate were detected between the two groups (P＜0.05). The healing time of wound was 8.66-16.23 days in the treatment group and 15.68-22.36 days in the control group. The healing time was significantly shorter in the treatment group than in the control group (P＜0.05). It is thus clear that vacuum sealing drainage has obvious advantages in repair of limbs’ open fracture with severe soft tissue injury compared with the conventional dressing.
