负压封闭松质骨移植一期植皮与开放植骨治疗创伤后骨髓炎疗效比较  

Comparison of cancellous bone grafting with vacuum assisted closure and one-stage skin grafting and traditional papineau technique in the treatment of post-traumatic osteomyelitis

作　　者：张继党 蔡锦方[1] 李宗玉[1] 解琛[1] 吴世奇[1] 

机构地区：[1]第二军医大学济南临床医学院济南军区总医院骨创科,山东济南250031

出　　处：《临床骨科杂志》2015年第5期590-593,共4页Journal of Clinical Orthopaedics

摘　　要：目的：评价创伤后骨髓炎采用负压封闭（ VAC）＋松质骨移植并一期植皮与传统开放植骨治疗的临床疗效。方法对35例创伤后骨髓炎患者分别采用VAC＋松质骨移植并一期植皮手术（16例）和传统开放植骨手术（19例）治疗。比较两种手术方法的创面的愈合时间和骨性愈合时间。结果患者均获得随访,A组随访时间为12~42（24±2.8）个月,B组随访时间为12~39（23．3±2．5）个月。创面愈合无渗出时间：A组为3~6（4．3±0．8）周,B组为5~10（7．5±1．2）周,两组比较差异有统计学意义（P〈0．001）。骨性愈合时间：A组为4~7（4．6±0．8）个月,B组为5~10（7．2±1．3）个月,两组比较差异有统计学意义（P〈0．001）。 A组患者随访1年未见复发。 B组随访1年,有2例患者复发。结论应用VAC＋松质骨移植并一期植皮治疗创伤后骨髓炎,创面愈合时间短,可迅速达到骨性愈合,复发率低,效果满意。Objective To evaluate the clinical outcome of post-traumatic osteomyelitis treated by cancellous bone grafting with vacuum assisted closure （ VAC） and one-stage skin grafting and papineau technique. Methods 35 ca-ses of post-traumatic osteomyelitis were treated by cancellous bone grafting with VAC and one-stage skin grafting（16 cases） and papineau technique（19 cases）,respectively. Wound healing time and bone healing time of the two kinds of the methods were compared. Results All cases were followed up. The follow-up time of group A ranged from 12~42 （24 ± 2. 8） months, group B ranged from 12 ~39 （23. 3 ± 2. 5） months. In group A,the average time of the wound without exudation was （4. 3 ± 0. 8） weeks（range 3 ~6 weeks）. In group B,the average time of the wound without exudation was （7. 5 ± 1. 2） weeks（range 5~10 weeks）. There was significant difference between two groups （P〈0. 001）. Meanwhile, the average time of the bone healing time of group A was （4. 6 ± 0. 8） months（range 4~7 months）, group B was （7. 2 ±1. 3） months（range 5~10 months）. There was significant difference between two groups（P〈0. 001）. During one year follow-up, no recurrence was found in group A, but 2 cases of recurrence were found in group B. Conclusions The cancellous bone grafting with VAC and one-stage skin grafting which is used to treat post-traumatic osteomyelitis can provide good clinical outcome, with less time of exudation, early bone healing and low incidence of recurrence.

关 键 词：负压封闭 松质骨移植 植皮 开放植骨 创伤后骨髓炎 

分 类 号：R681.2[医药卫生—骨科学] R687.34[医药卫生—外科学]