The timing of wound closure and the choice of methods in Gustilo Ⅲ type tibiofibula open fractures after emergency debridement
10.3760/cma.j.issn.1008-6706.2016.07.019
- VernacularTitle:GustiloⅢ型胫腓骨开放性骨折急诊清创后伤口闭合的时机与方法选择
- Author:
Liangjun LANG
;
Ling TANG
;
Yunbin ZHOU
- Publication Type:Journal Article
- Keywords:
Fractures,open;
Debridement;
Tibia;
Fibula
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(7):1030-1033
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the timing of wound closure and the choice of methods in Gustilo Ⅲtype tibiofibula open fractures after emergency debridement.Methods 42 patients with Gustilo Ⅲ type tibiofibula open fractures from January 2014 to January 2015 were selected as the observation group.All patients were performed emergency fracture fixation after debridement and wound secretion culture immediately after debridement, if the training result was positive,the debridement,again until the training results for negative when square in 48 hours after closing a wound.Selected 38 patients with GustiloⅢtype tibiofibula open fractures,the prompt debridement 38 cases were fracture fixed routine treatment after closing the wound,they were set as the control group.Compared two groups of patients with wound infection and fracture healing.Results The fractures wound infection rate of the observation group was 4.76%,which was significantly lower than 15.79% of the control group,the difference was statistically significant(χ2 =10.739,P=0.000).The wound healing time and fracture healing time of the observation group were significantly better than those of the control group,there were statistically significant differences( t=9.684,7.324,all P<0.05).Conclusion GustiloⅢtype emergency open tibiofibula fracture after debridement of the wound closure time should according to the results of wound secretion culture,cultivate the results can be achieved when the negative for wound closure,according to the degree of injury of soft tissue,to choose the right means of wound closure.
