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Abstract：
Traumatic osteomyelitis with accompanying soft tissue defects presents a significant therapeutic challenge. This prospective, randomised controlled trial aims to evaluate the efficacy of antibiotic-impregnated bone cement, flap coverage and negative pressure sealed irrigation in the management of traumatic osteomyelitis complicated by soft tissue defects. A total of 46 patients with clinically diagnosed traumatic osteomyelitis and soft tissue defects were randomised into a control group (n = 23) and an observation group (n = 23). The control group underwent standard flap coverage and negative-pressure lavage, while the observation group received an additional treatment with antibiotic-loaded bone cement. Efficacy was measured based on clinical criteria, surgical metrics and morphometric assessment of bone and soft tissue defects. Statistical analyses were performed using SPSS version 27.0. The observation group, treated with an integrated approach of flap coverage, negative pressure wound therapy (NPWT) and antibiotic-impregnated bone cement, demonstrated significantly higher overall treatment efficacy (91.3%) compared to the control group, which received only flap coverage and NPWT (65.2%) (p < 0.01). This enhanced efficacy was evidenced through various outcomes: the observation group experienced reduced surgical times, shorter hospital stays, fewer dressing changes and accelerated wound healing, all statistically significant (p < 0.001). Additionally, a quantitative analysis at 6-month post-treatment revealed that the observation group showed more substantial reductions in both bone and soft tissue defect sizes compared to the control group (p < 0.001). The multi-modal treatment strategy, combining skin flap coverage, antibiotic bone cement and negative-pressure irrigation, showed marked efficacy in treating traumatic osteomyelitis and associated soft tissue defects. This approach accelerated postoperative recovery and lowered costs.
摘要：
伴随软组织缺损的创伤性骨髓炎提出了重大的治疗挑战。这个未来,随机对照试验旨在评估抗生素骨水泥的疗效，皮瓣覆盖和负压封闭冲洗治疗创伤性骨髓炎并发软组织缺损。将46例临床诊断为创伤性骨髓炎伴软组织缺损的患者随机分为对照组(n=23)和观察组(n=23)。对照组行标准皮瓣覆盖和负压灌洗,而观察组接受了额外的抗生素骨水泥治疗。根据临床标准测量疗效，骨和软组织缺损的手术指标和形态学评估。使用SPSS版本27.0进行统计分析。观察组,用皮瓣覆盖的综合方法治疗，负压伤口治疗（NPWT）和抗生素浸渍骨水泥，与对照组相比，显示出明显更高的总体治疗效果（91.3％），仅接受皮瓣覆盖和NPWT（65.2％）（p<0.01）。通过各种结果证明了这种增强的疗效：观察组减少了手术时间，缩短住院时间,更少的敷料更换和加速伤口愈合，均具有统计学意义（p<0.001）。此外,治疗后6个月的定量分析显示,与对照组相比,观察组骨缺损和软组织缺损面积均显著减少(p<0.001).多模式治疗策略，结合皮瓣覆盖，抗生素骨水泥和负压冲洗，在治疗创伤性骨髓炎和相关的软组织缺损方面显示出明显的疗效。这种方法加速了术后恢复并降低了成本。
