Subatmospheric Pressure Dressings in the Temporary Treatment of Soft Tissue Injuries Associated With Type III Open Tibial Shaft Fractures in Children
| Autor: | Kathleen Punger, Brenda Kulp, Michael J. Morykwas, Jordan Simpson, Joseph Argenta, Lawrence X. Webb, Barnaby Dedmond, Bill Kortesis |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Financial costs medicine.medical_specialty Soft Tissue Injuries Adolescent Open wounds medicine.medical_treatment Bone healing Fractures Open medicine Humans Orthopedics and Sports Medicine Child Reduction (orthopedic surgery) Retrospective Studies Air Pressure Wound Healing Trauma Severity Indices Debridement business.industry Soft tissue General Medicine Bandages Surgery Tissue transfer Tibial Fractures Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Wound Infection Standard protocol Female business Follow-Up Studies |
| Zdroj: | Journal of Pediatric Orthopaedics. 26:728-732 |
| ISSN: | 0271-6798 |
| Popis: | PURPOSE This study was designed to evaluate the use of subatmospheric pressure dressings on high-energy open tibial shaft fractures in children. We hypothesized that the use of a negative-pressure dressing in these fractures would result in a decreased incidence of infection and decreased need for pedicled muscle flaps and free tissue transfer. METHODS A retrospective case series of 15 consecutive pediatric patients with 16 type III open tibial shaft fractures (8 type IIIA, 7 type IIIB, and 1 type IIIC). The patients' age ranged from 2 to 17 years. All patients underwent a standard protocol of serial irrigation and debridement of the open wound with bony stabilization. Temporary coverage of the open wound was obtained with the use of a subatmospheric pressure dressing until definitive wound coverage or closure. RESULTS Infection occurred in 5 of 16 fractures, 2 requiring antibiotics alone (1 type IIIA and 1 type IIIB) and 3 requiring surgical intervention (2 type IIIB and 1 type IIIC). Seven of 16 (3 type IIIA, 3 type IIIB, and 1 type IIIC) fractures required repeat surgical intervention to facilitate bony healing. Only 3 patients required free tissue transfers or rotational muscle flaps for coverage, a 50% decrease compared with the initial classification. CONCLUSIONS Compared with other described methods, the use of subatmospheric pressure dressings in the temporary treatment of soft tissue wounds associated with high-energy open tibial shaft may reduce the need for major soft tissue coverage procedures. Its effect on infection and fracture healing rates requires further study. SIGNIFICANCE A reduction in the need for major soft tissue coverage procedures with the use of negative-pressure dressings in this setting should result in decreased morbidity for these patients and in decreased social and financial costs. |
| Databáze: | OpenAIRE |
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