Ostermann P A, Ekkernkamp A, Henry S L, Seligson D
Department of Orthopaedic Surgery, School of Medicine, University of Louisville, KY 40292.
Zentralbl Chir. 1992;117(7):394-7.
A consecutive series of 119 type III B compound fractures in 103 patients was treated at the University of Louisville from May 1983 to May 1989. All patients had timely irrigation of their wounds, serial wound debridements, external skeletal stabilization and parenteral systemic antibiotics (penicillin, cefazolin, tobramycin). 96 open fractures were managed with the supplemental local use of tobramycin-PMMA-beads. There were 13.5% wound infections and 10.1% osteomyelitis observed. The additional local antibiotic therapy was of significant (p less than 0.001, p less than 0.025) benefit to lower both infectious complications. The amputation rate was overall 5%, 9.7% for the lower leg. Four patients died due to multiple trauma.
1983年5月至1989年5月期间，路易斯维尔大学对103例患者的119例III B型复合骨折进行了连续治疗。所有患者均及时进行了伤口冲洗、系列伤口清创、外骨骼固定及胃肠外全身抗生素治疗（青霉素、头孢唑林、妥布霉素）。96例开放性骨折采用了妥布霉素-聚甲基丙烯酸甲酯珠补充局部应用。观察到伤口感染率为13.5%，骨髓炎发生率为10.1%。额外的局部抗生素治疗对降低两种感染并发症均有显著益处（p<0.001，p<0.025）。总体截肢率为5%，小腿截肢率为9.7%。4例患者死于多发伤。
