Cargando…

Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures

BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged trea...

Descripción completa

Detalles Bibliográficos
Autores principales: Park, Chul Hyun, Shon, Oog Jin, Kim, Gi Beom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017177/
https://www.ncbi.nlm.nih.gov/pubmed/27746498
http://dx.doi.org/10.4103/0019-5413.189604
_version_ 1782452697770754048
author Park, Chul Hyun
Shon, Oog Jin
Kim, Gi Beom
author_facet Park, Chul Hyun
Shon, Oog Jin
Kim, Gi Beom
author_sort Park, Chul Hyun
collection PubMed
description BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study. The clinical results were assessed using a Puno scoring system for severe open fractures of the tibia at the last followup. The range of motion (ROM) of the knee and ankle joints and postoperative complication were evaluated at the last followup. The radiographic results were assessed using time to bone union, coronal and sagittal angulations and a shortening at the last followup. RESULTS: The mean score of Puno scoring system was 87.4 (range 67–94). The mean ROM of the knee and ankle joints was 121.3° (range 90°–130°) and 37.7° (range 15°–50°), respectively. Bone union developed in all patients and the mean time to union was 25.3 weeks (range 16–42 weeks). The mean coronal angulation was 2.1° (range 0–4°) and sagittal was 2.7° (range 1–4°). The mean shortening was 4.1 mm (range 0–8 mm). Three patients had partial flap necrosis and 1 patient had total flap necrosis. There was no superficial and deep wound infection. CONCLUSION: Staged treatment using NPWT decreased the risks of infection and requirement of flap surgeries in Gustilo Anderson grade IIIb open tibial fractures. Therefore, staged treatment using NPWT could be a useful treatment option for Gustilo Anderson grade IIIb open tibial fractures.
format Online
Article
Text
id pubmed-5017177
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-50171772016-10-14 Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures Park, Chul Hyun Shon, Oog Jin Kim, Gi Beom Indian J Orthop Original Article BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study. The clinical results were assessed using a Puno scoring system for severe open fractures of the tibia at the last followup. The range of motion (ROM) of the knee and ankle joints and postoperative complication were evaluated at the last followup. The radiographic results were assessed using time to bone union, coronal and sagittal angulations and a shortening at the last followup. RESULTS: The mean score of Puno scoring system was 87.4 (range 67–94). The mean ROM of the knee and ankle joints was 121.3° (range 90°–130°) and 37.7° (range 15°–50°), respectively. Bone union developed in all patients and the mean time to union was 25.3 weeks (range 16–42 weeks). The mean coronal angulation was 2.1° (range 0–4°) and sagittal was 2.7° (range 1–4°). The mean shortening was 4.1 mm (range 0–8 mm). Three patients had partial flap necrosis and 1 patient had total flap necrosis. There was no superficial and deep wound infection. CONCLUSION: Staged treatment using NPWT decreased the risks of infection and requirement of flap surgeries in Gustilo Anderson grade IIIb open tibial fractures. Therefore, staged treatment using NPWT could be a useful treatment option for Gustilo Anderson grade IIIb open tibial fractures. Medknow Publications & Media Pvt Ltd 2016-09 /pmc/articles/PMC5017177/ /pubmed/27746498 http://dx.doi.org/10.4103/0019-5413.189604 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Park, Chul Hyun
Shon, Oog Jin
Kim, Gi Beom
Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title_full Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title_fullStr Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title_full_unstemmed Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title_short Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures
title_sort negative pressure wound therapy for gustilo anderson grade iiib open tibial fractures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017177/
https://www.ncbi.nlm.nih.gov/pubmed/27746498
http://dx.doi.org/10.4103/0019-5413.189604
work_keys_str_mv AT parkchulhyun negativepressurewoundtherapyforgustiloandersongradeiiibopentibialfractures
AT shonoogjin negativepressurewoundtherapyforgustiloandersongradeiiibopentibialfractures
AT kimgibeom negativepressurewoundtherapyforgustiloandersongradeiiibopentibialfractures