| 封闭负压引流联合灌注冲洗治疗四肢骨折内固定术后感染 |
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投稿时间：2015-06-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 牛锋 |
NIU Feng |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
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| 傅强 |
FU Qiang |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
yzfq@163.com |
| 杨昌杰 |
YANG Chang-jie |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
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| 殷利民 |
YIN Li-min |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
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| 刘华根 |
LIU Hua-gen |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
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| 田涛 |
TIAN Tao |
扬州市中医院骨伤科, 江苏 扬州 225002 |
Department of Orthopaedics, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou 225002, Jiangsu, China |
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| 赖伟 |
LAI Wei |
伊犁州新源县中医院, 新疆 伊犁 835800 |
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| 期刊信息：《中国骨伤》2016年，第29卷，第7期，第651-654页 |
| DOI：10.3969/j.issn.1003-0034.2016.07.014 |
| 基金项目: |
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中文摘要:
目的：探讨封闭负压引流联合灌注冲洗治疗四肢骨折内固定术后感染的临床疗效。
方法：自2010年3月至2015年6月，采用封闭负压引流联合灌注冲洗治疗10例四肢骨折内固定术后感染患者，男7例，女3例；年龄11~58岁，平均34.4岁；病程1~8个月，平均4.8个月。尺桡骨骨折术后感染4例，胫腓骨骨折术后感染3例，跟骨骨折术后感染2例，股骨骨折术后感染1例。10例中开放性骨折术后感染8例，闭合性骨折术后感染2例。采用封闭负压引流联合灌注冲洗，结合全身及局部抗生素使用，换药或植皮。观察感染创面控制愈合速度和时间、负压封闭引流敷料（VSD）更换次数及原感染灶有无复发等。
结果：所有患者术后感染得到控制，伤口换药或植皮后愈合，无骨髓炎并发症发生，治疗时间29~45 d,平均38.4 d;更换VSD的次数1~4次，平均2.2次。10例患者均获得随访，时间1年，未见复发。
结论：封闭负压引流联合灌注冲洗技术治疗四肢骨折术后感染能有效促进感染伤口的生长和愈合，缩短愈合时间，是治疗四肢骨折内固定术后感染的有效方法。 |
| 【关键词】骨折 骨折固定术,内 感染 封闭负压引流 灌洗 |
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| Treatment of the postoperative infection of limbs fracture after internal fixation with vacuum sealing drainage (VSD) combined with continual irrigation |
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ABSTRACT
Objective: To explore the clinical effects of VSD combined with continual irrigation in treating the infection of limbs fracture after internal fixation.
Methods: From March 2010 to June 2015, 10 patients with infection of limbs fracture after internal fixation were treated with VSD combined with continual irrigation. There were 7 males and 3 females, aged from 11 to 58 years with an average of 34.4 years. Course of disease was from 1 to 8 months with an average of 4.8 months. Postoperative infection occurred in fractures of ulna and radius of 4 cases, tibiofibular fractures of 3 cases, calcaneal fractures of 2 cases, femoral fractures of 1 case. Eight infections were open fracture and 2 infections were close fracture. In additon to above treatment, antibiotics, dressing changing or skingrafting were used in the patients. Informations of wound surface healing, change dressings, original infection focus were observed.
Results: All infections got control, the wound healing after change dressings or skingrafting, and no complications such as osteomyelitis were found. The mean treatment time was 38.4 days(ranged, 29 to 45 days) and replacement times was 2.2 times(ranged, 1 to 4 times). All patients were followed up, no recurrent infections were found at 1 year after fracture healing.
Conclusion: VSD combined with continual irrigation can effectively decrease the incidence of complications and promote the wound growth, healing and considerably shorten the healing time. It is an effective method for the treatment of infection of limbs fracture after internal fixation. |
| KEY WORDS Fractures Fracture fixation,internal Infection Vacuum sealing drainage Irrigation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 牛锋,傅强,杨昌杰,殷利民,刘华根,田涛,赖伟.封闭负压引流联合灌注冲洗治疗四肢骨折内固定术后感染[J].中国骨伤,2016,29(7):651~654 |
| 英文格式: | NIU Feng,FU Qiang,YANG Chang-jie,YIN Li-min,LIU Hua-gen,TIAN Tao,LAI Wei.Treatment of the postoperative infection of limbs fracture after internal fixation with vacuum sealing drainage (VSD) combined with continual irrigation[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(7):651~654 |
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