Effect of VSD treatment on surgical indicators,inflammatory factors and functional recov-ery in patients with secondary bone infection after tibial fracture surgery
Objective To investigate the effect of vacuum sealing drainage(VSD)treatment on surgical indicators,inflammatory factors,and functional recovery in patients with chronic osteomyelitis sec-ondary to open tibial fractures.Methods 87 patients with secondary bone infection after internal fixation of tibial fracture treated in the Third Hospital of Hebei Medical University from December 2020 to June 2022 were selected,all of whom were tibial shaft fractures.55 cases of primary open fracture were sutured in the first stage;32 cases underwent internal fixation after primary debridement at the time of trauma;the patients were treated with surgical debridement,removal of internal fixation,and fixation with external fixation frame.After debridement,local wounds could not be completely closed,complicated with exposed bone,and VSD covering treatment(study group,n=46)or bone cement covering treatment(control group,n=41)were ran-domly selected,the distribution of pathogenic bacteria,surgical indicators,inflammatory factors[tumor ne-crosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)levels],functional recovery[knee,ankle and limb function recovery]and complications were summarized.Results There were 87 pathogenic bac-teria in 87 patients,including 43 Gram-positive bacteria(49.42%),32 Gram-negative bacteria(36.78%),and 12 fungi(13.80%).The number of dressing changes in the study group was less than that in the control group,and the infection control time,wound sterility time,hospitalization time,and skin flap transfer operation time in the study group were shorter than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α,IL-6,and CRP in the two groups decreased,among which the change in the study group was the most significant,and the difference was statistically significant(P<0.05).Af-ter treatment,the HSS and Baird-Jackson scores of the two groups increased,among which the change in the study group was the most significant,and the difference was statistically significant(P<0.05).The excellent and good rate of the study group(95.65%)was higher than the excellent and good rate of the control group(80.49%),and the difference was statistically significant(P<0.05).Conclusion Under the condition that the wound cannot be closed,VSD in the treatment of patients with secondary bone infection after internal fixation of tibial fracture can improve the level of surgical indicators,inflammatory factors levels in patients,and pro-mote the recovery of patients'limb function,which is worthy of clinical promotion and application.
VSDBone infection secondary to tibial fractureDistribution of pathogenic bacte-riaInflammatory factors
NETL
NSTL
万方数据
维普
