RETROSPECTIVE ANALYSIS OF THE IMPACT OF NEGATIVE PRESSURE WOUND THERAPY ON COMPLICATIONS OF DELAYED COVERAGE OF IIIB EXPOSED TIBIAL FRACTURES.

IF 0.6 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2025-12-01 eCollection Date: 2025-01-01 DOI:10.1590/1413-785220253303e290249

Theodoro da Cunha Gonzalez, Ivan Ribaric, Yuri Macari Gomes, Mbilu Miguel André, Fernando Quissolo Dalaia Zua, Maria Adelaide de Miranda Gonçalves, Mauricio Ivo, Marcos de Camargo Leonhardt, Jorge Dos Santos Silva, Kodi Edson Kojima

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引用次数: 0

Abstract

Objective: To evaluate whether NPWT in delayed coverage of Gustilo-Anderson Type IIIB open tibial fractures reduces the complication rate, including deep infection, nonunion, and amputation.

Methods: Retrospective case series including patients with Gustilo-Anderson Type IIIB open tibial shaft fractures treated between January 2014 and December 2017 with NPWT. The outcome measures were incidence of deep infection, nonunion, and amputation. Analysis of time to coverage (within 7 days vs. after 7 days) and type of soft tissue coverage.

Results: 26 patients with open tibial shaft fractures, predominantly male (96.2%), mean age 33.4 ± 13.9 years. Seven patients (26.9%) received coverage within 7 days; 19 patients (73.1%) received delayed coverage. The flap types were Myocutaneous (42.3%), microsurgical (34.6%), fasciocutaneous (23.1%). The overall infection rate was 50%, no significant difference between early (57.1%) and delayed (47.4%) coverage groups (p > 0.999). No amputations in the early coverage group; 2 (10.5%) in the delayed coverage group. Nonunion rates were 42.9% (early) and 36.8% (delayed). Overall complication rate: 85.7% (early) vs. 57.9% (delayed) (p = 0.357).

Conclusion: NPWT may exert a protective effect in cases of delayed coverage by isolating the wound and promoting healing. Level of Evidence III; Retrospective ^f study.

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负压创面治疗对iiib暴露胫骨骨折延迟复盖并发症影响的回顾性分析。

目的：评价NPWT延迟覆盖Gustilo-Anderson IIIB型胫骨开放性骨折是否能降低并发症发生率，包括深部感染、骨不连和截肢。方法：回顾性分析2014年1月至2017年12月期间接受NPWT治疗的Gustilo-Anderson IIIB型胫骨干开放性骨折患者。结果测量为深部感染、骨不连和截肢的发生率。覆盖时间分析（7天内vs. 7天后）和软组织覆盖类型。结果：胫骨干开放性骨折26例，男性占96.2%，平均年龄33.4±13.9岁。7名患者（26.9%）在7天内获得覆盖；19名患者（73.1%）接受了延迟覆盖。皮瓣类型以肌皮瓣（42.3%）、显微外科皮瓣（34.6%）、筋膜皮瓣（23.1%）为主。总感染率为50%，早期覆盖组（57.1%）与延迟覆盖组（47.4%）之间差异无统计学意义（p < 0.05）。早期覆盖组无截肢病例；延迟覆盖组2例（10.5%）。早期骨不连率为42.9%，延迟骨不连率为36.8%。总并发症发生率：85.7%（早期）vs 57.9%（延迟）（p = 0.357）。结论：NPWT可能通过隔离创面，促进创面愈合，对延迟覆盖的病例起到保护作用。证据等级III；回顾性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.