Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2011
[Conservative dressing change method in treatment of skin necrosis after open reduction with internal fixation of calcaneal fracture].
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Wang Jinhui, Wu Yong, Wang Yan, Wang Manyi
Аннотация
OBJECTIVE: To explore the effectiveness of conservative dressing change method in treating skin necrosis after open reduction with internal fixation (ORIF) of calcaneal fracture.
METHODS: Between November 2007 and June 2010, 21 cases of skin necrosis after ORIF of calcaneal fracture were treated, including 18 cases of Sanders type II and 3 cases of Sanders type III. There were 20 males and 1 female with an average age of 33.1 years (range, 23-60 years). All fractures were close fractures and were treated by ORIF with plate. Skin necrosis occurred at 3-5 days (mean, 4 days) after internal fixation. The interval of internal fixation and conservative dressing change was 3-10 days (mean, 6 days). Of 21 cases, 10 cases had superficial skin necrosis with a size range of 1-10 cm in length and 0.5-1.5 cm in width, and 11 cases had deep skin necrosis with a size range of 1-8 cm in length and 0.5-1.5 cm in width. The conservative dressing change method was performed. Alcohol (75%) was used at the edge of the zone of skin necrosis, whereas saline in the central of the wound every 2-3 days. The necrosed tissue in the wound was reserved as more as possible. No patient was given antibiotic.
RESULTS: Scab formed and subcrust healing was observed after 6-30 days (mean, 16 days) in 20 patients, 1 patient failed for discontinue treatment. No case had deep infection or osteomyelitis. The mean treatment time was 7.8 days (range, 6-14 days) in 10 cases of superficial skin necrosis, and was 23.1 days (range, 14-30 days) in 10 cases of deep skin necrosis. All cases were followed up 92 days on average (range, 54-123 days). The scar was usually dark red and hard, protruding from the normal skin. No patient had difficulty in weight bearing or walking.
CONCLUSION: Skin necrosis after ORIF of calcaneal fracture can be cured by the conservative dressing change method, and this conservative method is effective and economic.
METHODS: Between November 2007 and June 2010, 21 cases of skin necrosis after ORIF of calcaneal fracture were treated, including 18 cases of Sanders type II and 3 cases of Sanders type III. There were 20 males and 1 female with an average age of 33.1 years (range, 23-60 years). All fractures were close fractures and were treated by ORIF with plate. Skin necrosis occurred at 3-5 days (mean, 4 days) after internal fixation. The interval of internal fixation and conservative dressing change was 3-10 days (mean, 6 days). Of 21 cases, 10 cases had superficial skin necrosis with a size range of 1-10 cm in length and 0.5-1.5 cm in width, and 11 cases had deep skin necrosis with a size range of 1-8 cm in length and 0.5-1.5 cm in width. The conservative dressing change method was performed. Alcohol (75%) was used at the edge of the zone of skin necrosis, whereas saline in the central of the wound every 2-3 days. The necrosed tissue in the wound was reserved as more as possible. No patient was given antibiotic.
RESULTS: Scab formed and subcrust healing was observed after 6-30 days (mean, 16 days) in 20 patients, 1 patient failed for discontinue treatment. No case had deep infection or osteomyelitis. The mean treatment time was 7.8 days (range, 6-14 days) in 10 cases of superficial skin necrosis, and was 23.1 days (range, 14-30 days) in 10 cases of deep skin necrosis. All cases were followed up 92 days on average (range, 54-123 days). The scar was usually dark red and hard, protruding from the normal skin. No patient had difficulty in weight bearing or walking.
CONCLUSION: Skin necrosis after ORIF of calcaneal fracture can be cured by the conservative dressing change method, and this conservative method is effective and economic.