TREATMENT OF TIBIAL TRAUMATIC OSTEOMYELITIS WITH VACUUM SEALING DRAINAGE COMBINED WITH OPEN BONE GRAFT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DUQuanhong ¹ , CONGHaibo ² , SHIYongan ¹ , JIANGHui ¹ ,  SUIHaiming ¹

1. Department of Bone Hand Microsurgery, the Wendeng Osteopath Hospital, Weihai Shandong, 264400, P. R. China;
2. Department of Orthopedics, Weihai Wendeng Center Hospital;

Corresponding author：

SUIHaiming, Email: shm19660223@163.com

Keywords：

Traumatic osteomyelitis; Open bone graft; Vacuum sealing drainage

DOI：

10.7507/1002-1892.20140126

Video：

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Objective To explore the effectiveness of vacuum sealing drainage (VSD) combined with open bone graft for tibial traumatic osteomyelitis. Methods Between June 2007 and December 2012, 23 cases of tibial traumatic osteomyelitis were treated, including 15 males and 8 females with an average age of 32.5 years (range, 22-48 years). The time from injury to admission was 7-18 months (mean, 8.6 months). There was local bone scarring in 15 cases, the size ranged from 8 cm×4 cm to 15 cm×8 cm. The CT multi-planar reconstruction was carried out preoperatively. Eleven cases had segmental bone sclerosis with a length of 1.5 to 3.8 cm (mean, 2.6 cm); 12 cases had partial bone sclerosis with a range of 1/3 to 2/3 of the bone diameter. On the basis of complete debridement, infection was controlled by VSD; bone defect was repaired by VSD combined with open bone graft. After there was fresh granulation tissue, the wound was repaired by free skin graft or local skin flap transfer. Results Nail infection occurred in 2 cases, which was cured after the use of antibiotics. The wound healed at the first stage after repairing. All cases were followed up 10-18 months (mean, 13.5 months). In 11 cases of segmental bone sclerosis, the infection control time was 7-14 days (mean, 8.8 days); the bone healing time was 32-40 weeks (mean, 34.4 weeks); and the frequency of VSD was 3-6 times (mean, 4.5 times). In 12 cases of partial bone sclerosis, the infection control time was 7-12 days (mean, 8.3 days); the bone healing time was 24-31 weeks (mean, 27.3 weeks); and the frequency of VSD was 3-5 times (mean, 3.6 times). Infection recurred in 1 case, and the patient gave up the therapy. No infection recurrence was observed in the other patients. Conclusion The VSD combined with open bone graft is an effective method for the treatment of tibial traumatic osteomyelitis.

Citation： DUQuanhong, CONGHaibo, SHIYongan, JIANGHui, SUIHaiming. TREATMENT OF TIBIAL TRAUMATIC OSTEOMYELITIS WITH VACUUM SEALING DRAINAGE COMBINED WITH OPEN BONE GRAFT. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(5): 562-565. doi: 10.7507/1002-1892.20140126 Copy

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2.	黄雷, 刘兵, 李沂, 等. 开放植骨治疗感染性骨折不愈合. 中华骨科杂志, 2005, 25(1):30-34.
3.	Forberg JA, Potter BK, Cierny G 3rd, et al. Diagnosis and management of chronic infection. J Am Acad Orthop Surg, 2011, 19 Suppl 1:S8-S19.
4.	Caesar BC, Morgan-Jones RL, Warren RE, et al. Closed double-lumen suction irrigation in the management of chronic diaphyseal osteomyelitis:long-term follow-up. J Bone Joint Surg (Br), 2009, 91(9):1243-1248.
5.	曲龙. 骨搬移治疗骨缺损与骨不连. 北京:人民卫生出版社, 2009:4-45.
6.	Kelly KR, Kapatkin AR, Zwingenberger AL, et al. Efficacy of antibiotic-impregnated polymethylmethacrylate beads in a rhesus macaque (Macaca mulatta) with osteomyelitis. Comp Med, 2012, 62(4):311-315.
7.	唐延军, 刘建锋, 王宪俊, 等. 负压封闭引流技术. 万古霉素珠链填充治疗慢性创伤性骨髓炎. 中国临床研究, 2010, 23(1):42-43.
8.	Papineau LJ. Excision-graft with deliberately delayed closing in chronic osteomyelitis. Nouv Press Med, 1973, 2(41):2753-2755.
9.	Assadian O, Assadian A, Stadler M, et al. Bacterial growth kinetic without the influence of the immune system using vacuum-assisted closure dressing with and without negative pressure in an in vitro wound model. Int Wound J, 2010, 7(4):283-289.
10.	常炳营, 李华贵, 李宗一, 等. 病灶清除加髓腔持续负压封闭引流治疗胫骨慢性骨髓炎. 中国骨伤, 2011, 24(11):952-954.
11.	曾炳芳, 康庆林. 四肢骨不连外科学. 上海:人民军医出版社, 2010:310-311.
12.	Archdeacon MT, Messerschmitt P. Modern papineau technique with vacuum-assisted closure. J Orthop Trauma, 2006, 20(2):134-137.
13.	翟建国, 周硕霞, 丛海波, 等. 游离皮瓣移植结合骨段滑移技术治疗胫骨骨髓炎骨缺损. 中华显微外科杂志, 2012, 35(4):327-329.
14.	Tetsworth K, Cierny G 3rd. Osteomyelitis debridement techniques. Clin Orthop Relat Res, 1999, (360):87-96.

1. 李康华, 唐举玉, 刘俊, 等. 游离髂骨皮瓣移植一期修复胫骨创伤后骨髓炎骨缺损. 中华显微外科杂志, 2006, 29(2):132-134.
2. 黄雷, 刘兵, 李沂, 等. 开放植骨治疗感染性骨折不愈合. 中华骨科杂志, 2005, 25(1):30-34.
3. Forberg JA, Potter BK, Cierny G 3rd, et al. Diagnosis and management of chronic infection. J Am Acad Orthop Surg, 2011, 19 Suppl 1:S8-S19.
4. Caesar BC, Morgan-Jones RL, Warren RE, et al. Closed double-lumen suction irrigation in the management of chronic diaphyseal osteomyelitis:long-term follow-up. J Bone Joint Surg (Br), 2009, 91(9):1243-1248.
5. 曲龙. 骨搬移治疗骨缺损与骨不连. 北京:人民卫生出版社, 2009:4-45.
6. Kelly KR, Kapatkin AR, Zwingenberger AL, et al. Efficacy of antibiotic-impregnated polymethylmethacrylate beads in a rhesus macaque (Macaca mulatta) with osteomyelitis. Comp Med, 2012, 62(4):311-315.
7. 唐延军, 刘建锋, 王宪俊, 等. 负压封闭引流技术. 万古霉素珠链填充治疗慢性创伤性骨髓炎. 中国临床研究, 2010, 23(1):42-43.
8. Papineau LJ. Excision-graft with deliberately delayed closing in chronic osteomyelitis. Nouv Press Med, 1973, 2(41):2753-2755.
9. Assadian O, Assadian A, Stadler M, et al. Bacterial growth kinetic without the influence of the immune system using vacuum-assisted closure dressing with and without negative pressure in an in vitro wound model. Int Wound J, 2010, 7(4):283-289.
10. 常炳营, 李华贵, 李宗一, 等. 病灶清除加髓腔持续负压封闭引流治疗胫骨慢性骨髓炎. 中国骨伤, 2011, 24(11):952-954.
11. 曾炳芳, 康庆林. 四肢骨不连外科学. 上海:人民军医出版社, 2010:310-311.
12. Archdeacon MT, Messerschmitt P. Modern papineau technique with vacuum-assisted closure. J Orthop Trauma, 2006, 20(2):134-137.
13. 翟建国, 周硕霞, 丛海波, 等. 游离皮瓣移植结合骨段滑移技术治疗胫骨骨髓炎骨缺损. 中华显微外科杂志, 2012, 35(4):327-329.
14. Tetsworth K, Cierny G 3rd. Osteomyelitis debridement techniques. Clin Orthop Relat Res, 1999, (360):87-96.

Chinese Journal of Reparative and Reconstructive Surgery

TREATMENT OF TIBIAL TRAUMATIC OSTEOMYELITIS WITH VACUUM SEALING DRAINAGE COMBINED WITH OPEN BONE GRAFT

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