北京生物医学工程

封闭负压引流对胫骨平台骨折内固定术后感染处理的临床效果研究

Clinical effect of vacuum sealing drainage treatment on postoperative infection after internal fixation of tibial plateau fractures

作者：张丛笑王豫刘德全杨明连刘新房魏更生吴京亮左如俊

单位：北京海淀医院骨科(北京100080)

关键词：封闭负压引流胫骨平台骨折术后感染内固定

分类号：

出版年·卷·期（页码）：2012·31·4（411-414）

摘要：

目的胫骨平台骨折常伴随软组织严重损伤，因此术后多发感染。封闭负压引流(vacuum sealing drainage, VSD)通过在创面形成持续负压产生的机械学和生物学效应可有效促进创面愈合。本文通过临床实验对比研究，探讨封闭负压引流术对胫骨平台骨折内固定术术后感染处理的临床效果。方法对28例胫骨平台骨折内固定病例进行术后跟踪，其中16例发生术后感染，获得感染率及不同病原菌占比数据。之后以VSD处理的病例为实验组，以反复清创配合碘伏纱布缝合处理的病例为对照组，通过长期随访对两种方法的临床效果进行对比分析。结果 VSD组8例患者术后恢复时间的统计结果为(12.5±5.15) 月，反复清创组8例患者术后恢复时间的统计结果为(13.6±5.94)月。结论对Schatzker Ⅴ、Schatzker Ⅵ型术后感染率较高的胫骨平台骨折，两种术后处理方法均可获得较好的治疗效果。

Objective The postoperative infection rate of tibial plateau fractures is high since severe soft tissue injuries always come along with tibial plateau fractures. Vacuum sealing drainage (VSD) can accelerate wound healing through the mechanics and the biological effects of continuous negative pressure. The clinical effect of VSD treatment is investigated through clinical experiments. Methods Twenty-eight cases of internal fixation of tibial plateau fractures were studied to get the postoperative infection rate and the percentage of different pathogens. Then the clinical results of two different approaches were compared, one was VSD method and the other was repeated debridement and iodophor gauze suturing. Results The healing time of VSD group was (12.50±5.15) months (n=8) and that of the control group was (13.60±5.94) months (n=8). Conclusions The two approaches could achieve the equal clinical results for the postoperative infection treatment oftype V and VI fractures in Schatzker classification.

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