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目的探讨损伤控制下局部氧疗(TOT)结合灌洗与负压封闭引流术(VSD)在胫腓骨开放性粉碎骨折合并严重皮肤皮下剥脱伤治疗中的临床疗效。方法自2010-01—2013-09在损伤控制理论指导下,采用TOT结合灌洗与VSD技术治疗的胫腓骨开放性粉碎骨折并小腿严重皮肤皮下剥脱伤43例。结果所有病例均获随访,随访时间6~18个月,平均12个月,无一例感染,除2例骨不连外其余骨折均一期愈合,无皮肤坏死缺损、内植物外露及骨髓炎等并发症。结论损伤控制下TOT结合灌洗与VSD技术治疗的胫腓骨开放性粉碎骨折并小腿严重皮肤皮下剥脱伤能够有效减少并发症,减轻患者负担,是一种有效方法。
Objective To investigate the clinical effects of local oxygen therapy (TOT) combined with lavage and negative pressure closed drainage (VSD) under the control of injury in the treatment of tibiofibular open comminuted fractures combined with severe skin subcutaneous exfoliation. Methods From 2010-01-2013-09 under the guidance of the theory of trauma control, 43 cases of tibiofibular open comminuted fracture treated with TOT combined with lavage and VSD technique and severe skin subcutaneous exfoliation of lower leg were treated. Results All patients were followed up for 6-18 months with an average of 12 months without infection. All the remaining fractures were healed in one stage without skin necrosis defect, exudates and osteomyelitis disease. Conclusions TOT combined with lavage and VSD technique under the control of injury can effectively reduce the complications and reduce the burden of patients with open fractured tibiofibular fractures of the lower leg and skin, which is an effective method.