负压封闭引流(VSD)结合外固定支架在下肢开放性骨折合并软组织缺损治疗中的应用  

Application of vacuum sealing drainage plus external fixator in the treatment of lower limb open fracture with soft tissue defect

作　　者：谢春雷[1] 陈孜[1] 姚爱明[1] 刘凯[1] 冯斌[1] 

机构地区：[1]徐州医学院附属医院急救中心创伤外科,江苏徐州221002

出　　处：《徐州医学院学报》2009年第12期837-839,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨治疗下肢开放性骨折的有效方法。方法3年来收治17例下肢开放性骨折患者,采用负压封闭引流（VSD）加外固定支架治疗,清创后骨折用外固定支架固定,创面或创腔用VSD材料覆盖,接负压封闭吸引,5-9天后二期缝合、植皮或皮瓣转移。结果本组17例创面均愈合,骨折一期临床愈合14例（82.4%）,延迟愈合3例（17.6%）,无骨不愈合,平均愈合时间6.5个月。浅表感染2例（11.6%）,针道感染3例（17.6%）。结论VSD结合外固定支架治疗下肢开放性骨折,在迅速有效地稳定骨折的同时,能安全有效地封闭创面,缩短二期创面修复时间,促进骨折愈合,减少并发症。Objective To investigate the effective approaches in the treatment of lower limb open fracture with soft tissue defect by external fixator combined with vacuum sealing drainage（VSD）.Methods 17 patients with lower limb open fracture were treated by external fixator following debridement.Wound surface or cavities were filled with polyvinyl alcohol foams with embedded drainage tubes connected to vacuum bottle.The wounds were closed with secondary suturing,or skin transplation,or local flap grafting 5 to 9 days later.Results The wounds of 17 patients all healed.14 cases（82.4%） had bone primary union,and 3 cases（17.6%） had delayed union.The average union time was 6.5 months.There was pin-tract infection in 3 cases（17.6%） and superficial infection in 2 cases（11.6%）.Conclusion VSD combined with external fixator is a simple and effective treatment method for lower limb open fracture with soft tissue defect in that it can provide effective and rapid fixation,seal wounds,shorten secondary healing time of wounds,facilitate fracture and reduce the incidence of complications.

关 键 词：负压封闭引流 外固定 骨折 开放性 下肢骨折 

分 类 号：R683.42[医药卫生—骨科学]