Analysis of early curative effect of infertion control 26 adults GustiloIIIB open tibial fractures treated by the VSD with antibiotic loaded cement spacers

Abstract

Objective To analyze the early curative effect of 26 cases with adult Gustilo ⅢB open tibial fractures treated by the vacuum sealing drainage with antibiotic loaded cement spacers. Methods A totle of 26 patients with GustiloⅢB open tibial fractures in our hospital from January 2011 January to January 2016 were treated by the vacuum sealing drainage with antibiotic loaded cement spacers in surgery. The bone defect was filled by antibiotic loaded cement spacers after fracture was firmly fixed,and the wound was coverred by the vacuum sealing drainage on the end.In different stages of treatment,we would summarize inflammatory indicators.At last time we would do skin flap transplantation to the wound which was clean or we would continue to do the debridement and change antibiotic loaded cement spacers with the vacuum sealing drainage.After the first debridement,we defected the blood sedimentation, creactive protein, neutrophil percentage, etc after debridement and recorded the drain amount which was done bacterial culture on time from vacuum sealing drainage.In the second debridement,we evaluated whether antibiotic loaded cement spacers filled befect sufficiently,and the wound was clean. After finished skin flap transplantation,we assessed the time of infection control and the number of debridement. Results These patients with GustiloⅢB open tibial fractures went thought about one or two times and the infection was controlled effectively in an average of (7.5±2.3)days. All inflammatory markers of these patients are significantly increased within 24 hours after surgery and leveled off from 49 to 75 hours after sugery. What's more, the inflammatory index declined obviously, and returns to normal after 98 hours of the first debridement.We done cultures to testfluid drainage from vacuum sealing drainage and remaindered no bacterial growed.We saw that antibiotic loaded cement spacers fully filled in bone defect,and the wound was clean and there was a lot of fresh granulation tissue and no rheum. Conclusions To treat adult GustiloⅢB open tibial fractures,the vacuum sealing drainage with antibiotic loaded cement spacers can more effectively control the infection、short the average day in hospital and fill in bone defect adequately.This technique can lay the foundation of fixation treatment. This technology is worth popularizing in clinical. Key words: GustiloⅢB open tibial fractures; Vacuum sealing drainage; Antibiotic loaded cement spacers