负压封闭引流技术治疗足踝部开放性骨折脱位

目的观察负压封闭引流(VSD)技术应用于足踝部开放性骨折脱位治疗的临床结果。方法收集2006年3月至2010年3月收治的足踝部开放性骨折脱位患者520例,其中406例接受VSD治疗(VSD治疗组),114例接受常规清创换药治疗(换药组)。结果全部患者获随访2～5年,平均为3.5年。VSD组与换药组浅表感染率分别为5.17%和10.53%,细菌培养阳性率分别为1.03%和11.43%,术后GustilloⅡ型、Ⅲ型软组织损伤优良率分别为83.19%、75.96%和50.63%、31.43%,VSD组与换药组间差异有统计学意义(P<0.05)。结论利用VSD技术治疗足踝部开放性骨折脱位可降低感染率,提高治疗效果,是一种安全有效的治疗方法。

Constant vacuum sealing drainage technology for open fracture-dislocation of the foot and ankle

Objective To observe the clinical efficacy of vacuum sealing drainage(VSD) technology for treatment of open fracture-dislocation of the foot and ankle.Methods From March 2004 to March 2009,a total of 520 cases with open fracture-dislocation of foot and ankle were divided into 2 groups according to the treatment technology: 406 cases(361 males and 24 females) were treated by VSD technology(VSD group),the rest 114 cases were treated with conventional dressing change(DC group).Results Cases were followed up for 2-5 years(average of 3.5 years).The superficial infection rate and positive culture rate of bacteria were 5.17% and 1.03% in VSD group vs.10.53% and 11.43% in DC group.The excellent-to-good rate of Gustillo type Ⅱ and Gustillo type Ⅲ after surgery were 83.19% and 75.96% in VSD group vs.50.63% and 31.43% in DC group.The differences between groups were statistically significant(P<0.05).Conclusions Comparing to conventional dressing change technology,the VSD could reduce infection rate and increase good results,it is an effective and better choice for open fracture-dislocation of the ankle and foot.