Soft Tissue Management in Open Fractures of the Lower Leg: The Role of Vacuum Therapy |
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Authors: | Mario Rancan MD Marius Keel |
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Institution: | (1) Department of Surgery, Triemli Hospital, Zurich, Switzerland;(2) Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland;(3) Department of Orthopaedic Surgery, Inselspital Bern, Bern, Switzerland;(4) Centre for Clinical Research, University of Zurich, Zurich, Switzerland;(5) Department of Surgery, Triemli Hospital, Birmensdorferstrasse 497, 8063 Zurich, Switzerland |
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Abstract: | Abstract
The management of severe open fractures of the lower leg continues to challenge the treating surgeon. Major difficulties include
high infection rates as well as adequate temporary soft tissue coverage. In the past, these injuries were commonly associated
with loss of the extremity. Today, vacuum therapy provides not only safe temporary wound coverage but also conditioning of
the soft tissues until definitive wound closure. Amongst other advantages, bacterial clearance and increased formation of
granulation tissue are attributed to vacuum therapy, making it an extremely attractive tool in the field of wound healing.
However, despite its clinical significance, which is underlined by a constantly increasing range of indications, there is
a substantial lack of basic research and well-designed studies documenting the superiority of vacuum therapy compared to alternative
wound dressings. Vacuum therapy has been approved as an adjunct in the treatment of severe open fractures of the lower leg,
complementing repeated surgical debridement and soft tissue coverage by microvascular flaps, which are still crucial in the
treatment of these limb-threatening injuries. Vacuum therapy has in general proven useful in the management of soft tissue
injuries and, since it is generally well tolerated and has low complication rates, it is fast becoming the gold standard for
temporary wound coverage in the treatment of severe open fractures of the lower leg. |
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Keywords: | " target="_blank"> Vacuum therapy Factures Lower limb injuries Soft tissue injuries and infection Wound healing |
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