Acta ortopedica brasileira · 2025
RETROSPECTIVE ANALYSIS OF THE IMPACT OF NEGATIVE PRESSURE WOUND THERAPY ON COMPLICATIONS OF DELAYED COVERAGE OF IIIB EXPOSED TIBIAL FRACTURES.
СтатьяНазвание и аннотация: Перевод в очереди
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Gonzalez Theodoro da Cunha, Ribaric Ivan, Gomes Yuri Macari, André Mbilu Miguel, Zua Fernando Quissolo Dalaia, Gonçalves Maria Adelaide de Miranda, Ivo Mauricio, Leonhardt Marcos de Camargo, Silva Jorge Dos Santos, Kojima Kodi Edson
Аннотация
OBJECTIVE: To evaluate whether NPWT in delayed coverage of Gustilo-Anderson Type IIIB open tibial fractures reduces the complication rate, including deep infection, nonunion, and amputation.
METHODS: Retrospective case series including patients with Gustilo-Anderson Type IIIB open tibial shaft fractures treated between January 2014 and December 2017 with NPWT. The outcome measures were incidence of deep infection, nonunion, and amputation. Analysis of time to coverage (within 7 days vs. after 7 days) and type of soft tissue coverage.
RESULTS: 26 patients with open tibial shaft fractures, predominantly male (96.2%), mean age 33.4 ± 13.9 years. Seven patients (26.9%) received coverage within 7 days; 19 patients (73.1%) received delayed coverage. The flap types were Myocutaneous (42.3%), microsurgical (34.6%), fasciocutaneous (23.1%). The overall infection rate was 50%, no significant difference between early (57.1%) and delayed (47.4%) coverage groups (p > 0.999). No amputations in the early coverage group; 2 (10.5%) in the delayed coverage group. Nonunion rates were 42.9% (early) and 36.8% (delayed). Overall complication rate: 85.7% (early) vs. 57.9% (delayed) (p = 0.357).
CONCLUSION: NPWT may exert a protective effect in cases of delayed coverage by isolating the wound and promoting healing. Level of Evidence III; Retrospective f study.
METHODS: Retrospective case series including patients with Gustilo-Anderson Type IIIB open tibial shaft fractures treated between January 2014 and December 2017 with NPWT. The outcome measures were incidence of deep infection, nonunion, and amputation. Analysis of time to coverage (within 7 days vs. after 7 days) and type of soft tissue coverage.
RESULTS: 26 patients with open tibial shaft fractures, predominantly male (96.2%), mean age 33.4 ± 13.9 years. Seven patients (26.9%) received coverage within 7 days; 19 patients (73.1%) received delayed coverage. The flap types were Myocutaneous (42.3%), microsurgical (34.6%), fasciocutaneous (23.1%). The overall infection rate was 50%, no significant difference between early (57.1%) and delayed (47.4%) coverage groups (p > 0.999). No amputations in the early coverage group; 2 (10.5%) in the delayed coverage group. Nonunion rates were 42.9% (early) and 36.8% (delayed). Overall complication rate: 85.7% (early) vs. 57.9% (delayed) (p = 0.357).
CONCLUSION: NPWT may exert a protective effect in cases of delayed coverage by isolating the wound and promoting healing. Level of Evidence III; Retrospective f study.