目的 探讨外固定支架结合负压封闭引流(VSD)技术在GustiloⅢ型开放性骨折中的治疗效果.方法 应用外固定支架固定骨折断端,VSD创面引流后行二期皮瓣移植或植皮覆盖创面治疗43例GustiloⅢ型开放性骨折.结果 43例GustiloⅢ型开放性骨折随访时间为6个月~3年,平均1.5年.创面经VSD封闭引流后直接缝合8例,占18.6%,游离植皮26例,占60.47%,皮瓣移植9例,占20.93%;外固定拆除时间为1.5～8个月,平均3.1个月;骨折一期愈合39例,占90.69%,延期愈合1例;骨不连2例.本组有2例在拆除VSD后出现肉芽创面铜绿色假单胞菌感染,占6.98%,外固定钉道感染2例,占4.65%.结论 应用外固定支架结合VSD技术治疗GustiloⅢ型开放性骨折,具有操作简单、损伤小、费用低廉、可缩短治疗时间等优点.%Objective To investigate the treatment of external fixation combined with VSD technology in the treatment of open fractures of Gustilo Ⅲ. Methods After the application of external fixation of fracture fragments and VSD wound drainage, late flap transplant or skin graft were performed to cover the wound surface of 43 cases with Gustilo Ⅲ type of open fractures. Results Forty - three Gustilo Ⅲ type cases with open fractures were followed - up for 6 months to 3 years, with an average of 1.5 years; after the drainage of the wound through the VSD, directly closed suture was performed in 8 cases (18. 6% ), skin graft in 26 cases, accounting for 60. 47% , and flap transplantation in 9 cases, accounting for 20. 93% ; the removal time of external fixation was 1.5 months to 8 months, with an average time of 3. 1 months; fracture healing in 39 cases accounted for 90. 69% , delayed healing happened in 1 case, and bone nonunion in 2 cases. In this group of patients, granulation aeruginous pseudomonas infection occurred in 2 cases after the removal of VSD, which accounted for 6. 98% ; the external fixation pin tract infection in 2 cases, which accounted for 4. 65% . Conclusion The application of external fixator combined with VSD treatment of Gustilo Ⅲ type open fractures is simple, low - cost operation with small injury, which can shorten the treatment time, reduce the economic burden of patients, and alleviate the suffering of the patients.
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