采用外固定、负压伤口治疗和重组人骨形态发生蛋白7成功治疗的IIIC级开放性胫骨骨折
Open tibial fractures grade IIIC treated successfully with external fixation, negative-pressure wound therapy and recombinant human bone morphogenetic protein 7.
作者信息
Babiak Ireneusz
机构信息
Department of Orthopaedics and Traumatology, Medical University of Warsaw, Warszawa, Poland.
出版信息
Int Wound J. 2014 Oct;11(5):476-82. doi: 10.1111/j.1742-481X.2012.01112.x. Epub 2012 Nov 19.
Abstract
The aim of the therapy in open tibial fractures grade III was to cover the bone with soft tissue and achieve healed fracture without persistent infection. Open tibial fractures grade IIIC with massive soft tissue damage require combined orthopaedic, vascular and plastic-reconstructive procedures. Negative-pressure wound therapy (NPWT), used in two consecutive cases with open fracture grade IIIC of the tibia diaphysis, healed extensive soft tissue defect with exposure of the bone. NPWT eventually allowed for wound closure by split skin graft within 21-25 days. Ilizarov external fixator combined with application of recombinant human bone morphogenetic protein-7 at the site of delayed union enhanced definitive bone healing within 16-18 months.
摘要
III级开放性胫骨骨折的治疗目的是用软组织覆盖骨骼并实现骨折愈合且无持续性感染。伴有大面积软组织损伤的IIIC级开放性胫骨骨折需要联合骨科、血管和整形重建手术。负压伤口治疗（NPWT）应用于两例连续性胫骨干IIIC级开放性骨折患者，治愈了伴有骨外露的大面积软组织缺损。NPWT最终使得在21至25天内通过植皮实现伤口闭合。Ilizarov外固定器结合在骨不连部位应用重组人骨形态发生蛋白-7，在16至18个月内促进了确定性骨愈合。
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本文引用的文献
1
Advances in wound healing: a review of current wound healing products.
Plast Surg Int. 2012;2012:190436. doi: 10.1155/2012/190436. Epub 2012 Mar 22.
2
Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus.
J Plast Reconstr Aesthet Surg. 2011 Sep;64 Suppl:S1-16. doi: 10.1016/j.bjps.2011.06.001. Epub 2011 Aug 24.
3
Fix and flap in the era of vacuum suction devices: What do we know in terms of evidence based medicine?
Injury. 2010 Aug;41(8):780-6. doi: 10.1016/j.injury.2009.08.011. Epub 2010 May 14.
4
The treatment of gustilo grade IIIB tibia fractures with application of antibiotic spacer, flap, and sequential distraction osteogenesis.
Ann Plast Surg. 2010 May;64(5):541-52. doi: 10.1097/SAP.0b013e3181cf9fb5.
5
Bone morphogenetic proteins in open fractures: past, present, and future.
Injury. 2009 Dec;40 Suppl 3:S27-31. doi: 10.1016/S0020-1383(09)70008-7.
6
Immediate versus delayed intramedullary nailing for open fractures of the tibial shaft: a multivariate analysis of factors affecting deep infection and fracture healing.
Indian J Orthop. 2008 Oct;42(4):410-9. doi: 10.4103/0019-5413.43385.
7
A health economic analysis of the use of rhBMP-2 in Gustilo-Anderson grade III open tibial fractures for the UK, Germany, and France.
Injury. 2009 Dec;40(12):1269-75. doi: 10.1016/j.injury.2009.02.007. Epub 2009 Jun 18.
8
A cost analysis of treatment of tibial fracture nonunion by bone grafting or bone morphogenetic protein-7.
Int Orthop. 2009 Oct;33(5):1407-14. doi: 10.1007/s00264-008-0709-6. Epub 2008 Dec 4.
9
The role of bone morphogenetic protein-7 (Osteogenic Protein-1) in the treatment of tibial fracture non-unions. An overview of the use in Belgium.
Acta Orthop Belg. 2008 Aug;74(4):534-7.
10
RhBMP-7 accelerates the healing in distal tibial fractures treated by external fixation.
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