73例真空封闭引流灌洗治疗闭合骨折内固定术后感染的回顾性分析

Retrospective Analysis of 73 Cases of Infection after Closed Fracture and Internal Fixation Treated by Vacuum Sealing Drainage and Lavage

摘要: 目的：骨折内固定术后感染是骨科最常见的并发症之一，其治疗困难且昂贵，在本研究中，我们打算探究闭合骨折内固定术后感染的伤口管理，以控制感染，缩短治疗时间，提高骨折愈合率。方法：本回顾性分析探究了骨折内固定术后感染患者的感染治疗情况及内固定装置保留情况。采用抗菌治疗及全身支持治疗、伤口广泛彻底清创、VSD真空封闭引流灌洗等治疗方法。结果：73名患者感染均得到成功控制，尝试保留内固定装置的47例患者中，保留失败15例，保留成功32例。平均灌洗时间20.73 ± 12.41天。结论：我们的经验表明，真空封闭引流加灌洗在治疗骨折内固定术后感染及保留内固定装置方面具有显著疗效。

Abstract: Objective: Infection after internal fixation of fractures is one of the most common complications in orthopaedics, and its treatment is difficult and expensive. In this study, we intend to investigate wound management of infection after closed fracture internal fixation to control infection, shorten treatment time, and improve fracture healing rates. Methods: This retrospective analysis investigated the infection treatment and retention of internal fixation devices in patients with infection after internal fixation of fractures. Antibacterial therapy, systemic supportive therapy, extensive and thorough wound debridement, vacuum sealing drainage and lavage were used. Results: Infections of 73 patients were successfully controlled. Among the 47 patients who attempted to retain the internal fixation device, retention failed in 15 cases and successful retention in 32 cases. The average lavage time was 20.73 ± 12.41 days. Conclusion: Our experience shows that vacuum sealing drainage with lavage has a significant effect in treating surgical site infection and retaining the internal fixation device.