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Abstract：
Background Open fractures are common and serious injuries that primarily affect young males. Fracture management has improved in the last decade. However, infections with their complications are still a concern, especially in open fractures for primary closure of the injured area. A newer technique called vacuum-assisted therapy has become a therapy of choice for many orthopedic surgeons. This study aimed to determine whether vacuum-assisted closure reduces the duration of wound healing and the frequency of infections after fixation of Gustilo-Anderson Type IIIA/IIIB fractures of the extremities. Methodology An observational analytical study was conducted among 34 patients with Gustilo-Anderson Type IIIA/IIIB fractures of the limbs who presented to the Department of Orthopaedics, R. L. Jalappa Hospital, Kolar, from December 2019 to July 2021. Negative-pressure wound therapy was employed for wound closure after fixation of fractures. Patients were followed up for one month. Results The mean age of the patients was 37.06 ± 10.340 years. The prevalence of infection before vacuum-assisted closure dressing was 80.6%, and the prevalence of infection after vacuum-assisted closure dressing was 19.4%. The difference in proportion before versus after the intervention was statistically significant (p < 0.001) according to the McNemar Test. Hence, vacuum-assisted closure dressing decreased the rate of infection. The mean dimension of the wound before vacuum-assisted closure therapy was 66.05 cm2 and the mean dimension of the wound after vacuum-assisted closure therapy was 27.97 cm2. The difference in the mean before and after the intervention was statistically significant according to the paired t-test (p < 0.001). Hence, vacuum-assisted closure dressing helped decrease the wound size which was proven statistically. Conclusions Vacuum-assisted closure is a viable and beneficial treatment option for complicated fractures with large soft-tissue abnormalities.
摘要：
背景技术开放性骨折是主要影响年轻男性的常见且严重的损伤。在过去十年中，骨折管理有所改善。然而,感染及其并发症仍然是一个令人担忧的问题，特别是在开放性骨折中，初次闭合受伤区域。一种称为真空辅助疗法的较新技术已成为许多整形外科医生的首选疗法。这项研究旨在确定真空辅助闭合是否可以减少Gustilo-Anderson四肢IIIA/IIIB型骨折固定后伤口愈合的持续时间和感染频率。方法一项观察性分析研究是在34名接受骨科治疗的Gustilo-AndersonIIIA/IIIB型四肢骨折患者中进行的，R.L.Jalappa医院,Kolar,从2019年12月到2021年7月。负压伤口疗法用于骨折固定后的伤口闭合。患者随访1个月。结果患者平均年龄为37.06±10.340岁。真空辅助闭合敷料前的感染率为80.6%，真空辅助闭合敷料后感染的患病率为19.4%。根据McNemar检验，干预前后的比例差异具有统计学意义（p<0.001）。因此，真空辅助闭合敷料降低了感染率。真空辅助闭合治疗前伤口的平均尺寸为66.05cm2,真空辅助闭合治疗后伤口的平均尺寸为27.97cm2。根据配对t检验，干预前后的平均值差异具有统计学意义（p<0.001）。因此，真空辅助闭合敷料有助于减少伤口大小，这在统计学上得到证实。结论对于伴有较大软组织异常的复杂骨折，真空辅助闭合是一种可行且有益的治疗选择。
