负压封闭引流与外支架固定及邮票植皮术治疗上肢开放性骨折并软组织缺损

目的 探讨联合应用负压封闭引流(VSD)与外支架固定及邮票植皮术治疗上肢开放性骨折合并大面积软组织缺损的临床疗效.方法 2009-01～2011-08,对本院收治的16例上肢开放性骨折合并大面积软组织缺损患者,清创后骨折用外支架固定,创面用VSD材料覆盖,接负压封闭吸引,二期邮票植皮.结果 本组16例创面均愈合,其中创面感染6例.随访时间为6个月～1年6个月,平均8个月,骨折一期临床愈合13例,延迟愈合3例,平均愈合时间4.6个月.结论 联合应用VSD、外支架固定及邮票植皮术治疗上肢开放性骨折伴大面积软组织缺损,能迅速有效地稳定骨折,患者可以提前活动患肢,同时安全有效地封闭创面,局限感染灶,促进骨折愈合;VSD术后肉芽组织新鲜,二期植皮易活,取皮方便.该方法 治疗周期短,并发症少,是一种简便有效的治疗方法.

Treating upper limb open fracture with soft tissue defects by using vacuum sealing drainage, external fixation and stamp skin grafting

Objective To study the curative effect of using vacuum sealing drainage,external fixation and stamp skin grafting in the treatment of upper limbs open fracture with soft tissue defect.Methods From January 2009 to August 2011,16 patients with upper limbs open fracture with soft tissue defect in the hospital were cured by external fixation after wound debridement.The wounds were covered with VSD materials,then linked to the closed negative pressure attracting device,then closing wound with stamps skin grafting.Results The result of this surgical method were satisfied.The wounds of 16 patients all healed finally.Six patients’ wounds were infected.All patients were followed up for 6 months to 1 year and 6 months(with an average of 8 months).Thirteen cases showed bone primary union in 3 months and 3 cases showed delayed union in 6 months.The average time of fracture healing was 4.6 months.Conclusion This method treating upper limbs open fracture with soft tissue defect by using vacuum sealing drainage,external fixation and stamp skin grafting can fix fractures effectively and quickly.Patients treating with this surgery could exercise the affected limbs early.At the same time wounds were closed safely and effectively. Focal infection were limited with the help of VSD.This condition promoted the fracture healing.The granulation tissue were fresh after VSD.The skin lived easily and was got conveniently.This operation is a convenient and effective treatment method for treating upper limbs open fracture with soft tissue defects.