摘要
内固定装置是创伤性、开放性、下肢骨折后骨巩固的重要矫形器材。1，2切开复位内固定后(s/p)骨科伤口感染状况是一个重要的并发症和发病率指标。矫形硬件的移除和手术修改是昂贵的，并需要额外的时间在手术室。使用负压伤口治疗(灌注和停留时间)有效清洁感染的外科整形伤口可能是一种切实可行的干预措施。在这里，4例(n = 4)创伤性下肢开放性骨折的伤口感染患者(n = 4)采用NPWTi-d进行治疗。伤口组织培养并进行微生物检测。为了治疗感染，根据培养敏感性报告给予抗生素。必要时进行清创。为促进创面清洁，使用1/8强度的Dakin’s Solution (NaOCl;次氯酸钠)使伤口浸透10分钟，然后用2小时的负压(-125毫米汞柱)。每3天更换一次敷料。 NPWTi-d duration was 3 to 24 days. NPWTi-d was discontinued upon the patient achieving the therapeutic goal of a clean wound. Post culture assays ascertained no growth. The cleansed wounds were prepared for lower extremity reconstruction using either free tissue (muscle; n = 3) or local tissue (fascia cutaneous; n = 1). Full healing (90-day outcome) was noted in 100% of patients at the follow-up appointment with no need for hardware removal. In these patients, NPWTi-d was effective in cleansing post ORIF surgical wounds with infections and helped to prepare the wound for reconstruction surgery.
* V.A.C.VERAFLO™治疗(KCI，现在是3M的一部分)
参考文献
- McKissack HM, Viner GC, Jha AJ, Wilson JT, Anderson MC, McGwin G Jr, Shah AB.不同年龄组接受踝关节ORIF手术患者术后并发症的危险因素比较。受伤。2019年11月,50(11):2116 - 2122。doi: 10.1016 / j.injury.2019.09.014。9月12日。PMID: 31547967。
- Okelana AB, McMillan LJ, Kibble K, Parikh HR, Gorman C, Schaefbauer H, Cunningham BP。踝关节骨折植入物选择的差异:识别成本驱动因素。J Orthop Trauma. 2019 Nov;33 supp7:S26-S31。doi: 10.1097 / BOT.0000000000001623。PMID: 31596781。