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Flap Transplantation for Treating Open Fracture Wound after VSD

Tang Jiquan, Gan Ganda, Tao Zhigang, Luo Ping, Huang Yuhu

 

Department of Trauma and Microsurgery, the 181th Hospital of PLA, Guilin Guangxi

 

Objective: To explore clinical efficacy of taking flap transplantation to treat Gustilo IIIB and IIIC type open fracture wounds after VSD.

 

Methods: Thirty cases with Gustilo IIIB and IIIC type open fracture were taken emergency debridement. According to fracture type, kirschner wire and screw were used to make simple internal fixation, and external fixation was used to fix fracture end, if necessary. VSD treatment was taken for 7 to 10 days. After healing wound with flap transplantation, local free flaps were used in 8 cases, lateral malleolus E perforating flaps in 2 cases, sural nerve and its nourishing flaps in 5 case and anterolateral thigh flaps in 5 cases according to wound size and condition of surrounding skin defect and soft tissue defect.

 

Results: Flaps were alive in 30 cases. There was without infection. After following up for 1 to 2 years, all flaps were with good quality. At 4 to 10months after operation, X ray showed bone healing at 7 months in average, and there was without symptoms of osteomyelitis.

 

Conclusion: VSD can avoid dressing change, stimulate granulation growth, keep muscular tendon and bone substance fresh, and provide condition for stage II flap transplantation, in order to completely cover wound surface. After VSD treatment, flap transplantation can achieve good repairing efficacy for treating Gustilo IIIB and IIIC type open fracture.

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