Artificial dermis is not effective for resurfacing bone-exposing wounds of Gustilo–Anderson III fracture

摘要

According to the treatment of open fracture, the resurfacing of bone-exposing complex wounds of Gustilo-Anderson III B and C fracture remains challenging. To treat bone-exposing wounds, artificial dermis has been effective. We evaluated the outcome of adapting artificial dermis the resurfacing bone-exposing complex wounds of Gustilo-Anderson III B and C fracture clinically. Seven patients who had sustained Gustilo-Anderson III B and C fracture of the legs underwent open reduction and Ilizarov external fixation. The bone-exposing wounds were covered with slit artificial dermis, and a basic fibroblast growth factor was sprayed every day. Wounds in all patients showed insufficient granulation on the bone. Four patients developed osteomyelitis. Consequently, all cases required a local flap for resurfacing the wounds. Although the artificial dermis allows wounds to heal earlier, it is impossible to prepare a favorable wound bed on the bone when the fracture is classified as Gustilo-Anderson III B and C. We concluded that artificial dermis is not a recommendable resurfacing option for patients with Gustilo-Anderson III B and C fracture because the poor circulation of bone may result in osteomyelitis.