Negative pressure wound therapy For III grade open fracture AT Trauma centre Ostrava
Authors:
Jana Pometlová 1,2; Leopold Pleva 1,2; Jiří Szeliga 1; Milan Šírtraumatologické Centrum Fn Ostrava 1
Authors‘ workplace:
Trauma centre University Hospital Ostrava, 2Department od disaster, medical faculty University of Ostrava
1; Traumatologické centrum FN Ostrava, 2Ústav medicíny katastrof LF Ostravské univerzity
1
Published in:
Úraz chir. 22., 2014, č.1
Overview
Introduction:
High energy open fractures are serious injuries that frequently have complication. Their treatment requires complex interdisciplinary treatment to reduce the risk of infectious complications that may cause subsequent amputation. Reported deep infections rates range from 3 % to 66 %. Despite the improving treatment options occurrence of these complications remains high. It is not clear what type of temporary treatment haes better results.
Methodology:
A retrospective review of patients undergoing surgery for stage III open fractures at traumatology center FN Ostrava between 1. 1. 2008 and 31. 6. 2013. We looked for secondary amputations for soft tissue infections. We collected data of 126 patients with grade III open fractures, nine of them hadmore than one open fracture. Ninety patients undervent reconstructive surgery.
Results:
Ninety patients with 94 open fractures were included in the study. Negative pressure therapy were used in 24 cases, remaining 70 open fractures were treated with wet to dry wound therapy. Both groups were comparable in demographic terms and in terms of severity of extremity injury (assessed by Mangled extremity severity score) and the stage of the open fractures. In negative pressure wound therapy group we detected no infectious complications leading secondary amputation (0 %). In control group we performed 6 amputations for soft tissue infections (9 %). This difference was not statistically significant. (p=0,332, Fischer exact test).
Conclusion:
Negative pressure wound therapy represents promising posibility for temporary wound dressing after grade III open fractures. In our study we did not detect any patient with soft tissue infection requiring subsequent amputation in the negative pressure wound therapy group.
Key words:
Negative pressure wound therapy (NPWT), open fracture, amputation, MESS.
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2014 Issue 1
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