Clinical study of infection control on traumatic osteomyelitis

LIU Xue-guang; SUN Zhen-zhong; SONG Sheng; DU Shi-hao; ZHUANG Yin; ZHOU Ming; HAN Xiao-fei

doi:10.3969/j.issn.1009-4237.2018.06.017

Abstract：Objective To investigate the effect for the treatment of traumatic osteomyelitis of bone infection by continuous closed irrigation first and then vancomycin calcium sulfate implantation .Methods From Jul.2013 to Dec.2016,141 traumatic osteomyelitis patients were retrospectively analyzed.There were 121 males and 20 fe-males,with an average age of 43.7 years (from 27 to 73years),and the average course of 9.3 months(from 4 weeks to 19 months).There were 95 tibias (9 cases with fibula concurrence ),19 femurs,15 calcaneuses,6 humeruses,ul-na,radius and iliac bone in 2 cases, respectively.Bacterial culture was positive in 126 cases,of which gram positive cocci accounted for 57.1%(n＝72),gram negative bacilli accounted for 35.7%(n＝45),mixed infection accoun-ted for 7.1%(n＝9).And 61 cases (57 cases of tibia,3 cases of calcaneus and 1 case of ulna) had soft tissue de-fect in demand of skin flap transplantation.Results All cases were followed -up from 3 to 19 months(average, 8.7 months),the duration of continuous closed irrigation was 2-4 weeks(average 2.8 weeks),5 cases had VSD changed due to poor drainage.Calcium sulfate artificial bone was absorbed at 4 weeks,and was absorbed completely at 8 weeks.Three weeks after operation ,there were 107 cases (75.9%) healed in class Ⅰ,and 34 cases (24.1%) in class Ⅱ.Conclusion The way of thorough debridement ,eliminating dead space,sustained and effective load of vancomycin lavage combined with calcium sulfate is simple and has a good effect for the treatment of traumatic osteo -myelitis.It can avoid a series of adverse reactions caused by systemic delivery ,but the treatment time is long.