[Treatment of open fracture by vacuum sealing technique and internal fixation].
OBJECTIVE
To investigate the effect of vacuum sealing(VS) technique and emergency internal fixation on the management of limbs open fracture and soft tissue dirty defects.


METHODS
Fourteen patients (18 limbs) with open fracture and soft tissue dirty defects were treated by the VS technique and internal fixation after debridement and 14 patients managed by traditional method as control group. Wound surface were covered with polyvinyl alcohol foams with embedded drainage tubes connected with vacuum bottle (negative pressure of 50 to 60 kPa) after wound surface were debrided and fracture were fixed. Wound closure was performed with secondary suturing, or free flap, or loco-regional flap and mesh-grafts after 5 to 7 days.


RESULTS
All wound surface healed completely. No complications (systemic and local) were found. After 4-6 months follow-up on average, the fracture healed well. There was significant difference in time of treatment, total cost of treatment and complication rate between 2 groups (P < 0.01).


CONCLUSIONS
The VS procedure can drain the wound surface completely, decrease infection rate and stimulate the proliferation of granulation tissue. A combination of VS with emergency internal fixation is a simple and effective method in treatment of limbs open fracture and soft tissue dirty defects.
Huang
Jian
J
Department of Trauma, Third Affiliated Hospital, Third Military Medical University, Chongqing, P. R. China 400042.
Yao
Yuan-zhang
YZ
Huang
Xian-kai
XK
D000293:Adolescent; D000328:Adult; D000368:Aged; D003646:Debridement; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D013396:Suction; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery; D014618:Vacuum
D011142:Polyvinyl Alcohol