title: [Clinical application of continuous douche and vacuum sealing drainage in refractory tissue, bone and joint infections after debridement].
abstract: OBJECTIVE
  To explore effect and the application value of continuous douche and vacuum sealing drainage (VSD) in refractory tissue, and joint infections after complete debridement.
  
  
  METHODS
  As retrospective analysis of treatment time and restoration or recurrence, from Jan. 2006 to Dec. 2007, 61 cases of refractory tissue, bone and joint infections underwent continuous douche and VSD combined with the treatment of anti-inflammatory and rehabilitation training after debridement in our hospital. The 61 patients included 39 males and 22 females with age ranging from 10 to 58 years with an average of (35 +/- 12) years, among whom 61 identified to have ankle ulcers combined with infections,open fracture combined with infections, sacrococcygeal pressure ulcers combined with infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation were 11, 15, 9, 3, 5 and 18 cases respectively. The course was from 2 weeks to 11 months with an average of 4 months.
  
  
  RESULTS
  In all 61 patients,the mean healing time was 17, 36, 42, 24, 32, 29 and 28 days in ankle ulcers and infections, tibia and fibula open fracture and infections, femoral shaft fracture and infections, sacrococcygeal pressure ulcers and infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation respectively. The replacement of VSD was 1, 2-4, 3-5, 1-3, 2-4, 2-3 and 1-3 times in each group respectively. There was no wound recurrence except for 2 cases with recurrent in 61 cases with external fixation nail hole semi-pathological fracture in 1 case of femoral shaft fracture and infection and 1 case of tibia and fibula fracture and infection after follow-up at least one year.
  
  
  CONCLUSIONS
  Application of continuous douche and VSD can effectively decrease incidence of complications and promote the refractory tissue, bone and joint infections wound growth, healing and considerably shorten the healing time.
authors.affiliation: Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Traffic University, Xi'an 710004, Shaanxi, China. yplyplypl1974@163.com
authors.forename: Ping-lin
authors.initials: PL
authors.lastname: Yang
authors.forename: Xi-jing
authors.initials: XJ
authors.lastname: He
authors.forename: Hao-peng
authors.initials: HP
authors.lastname: Li
authors.forename: Guo-yu
authors.initials: GY
authors.lastname: Wang
authors.forename: Quan-jin
authors.initials: QJ
authors.lastname: Zang
mesh_terms: D000293:Adolescent; D000328:Adult; D001847:Bone Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D003646:Debridement / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013396:Suction / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult