未经证实:在严重创伤的情况下,下肢抢救需要考虑多种外科专业和治疗算法。我们假设第一次步行的时间到了,没有辅助设备的步行,慢性骨髓炎,延迟截肢不受我们机构GustiloIIIB和IIIC骨折软组织覆盖时间的影响.
UNASSIGNED:我们评估了2007年至2017年在我们机构接受胫骨开放性骨折治疗的所有患者。包括在初次住院期间需要对下肢进行任何形式的软组织覆盖的患者,并且从出院时起至少进行了30天的随访。对所有感兴趣的变量和结果进行单变量和多变量分析。
未经批准:纳入575名患者,89需要软组织覆盖。在多变量分析中,覆盖软组织的时间,负压伤口治疗的长度,伤口冲洗次数未发现与慢性骨髓炎的发展有关,减少90天返回任何步行,在没有辅助设备的情况下减少了180天的步行时间,或延迟截肢。
UNASSIGNED:胫骨开放性骨折软组织覆盖时间不影响首次下床活动时间,没有辅助设备的步行,慢性骨髓炎,或延迟截肢。仍然很难明确证明软组织覆盖时间对下肢结果有意义。
UNASSIGNED: Lower extremity salvage in the setting of severe trauma requires the consideration of multiple surgical specialties and treatment algorithms. We hypothesized that time to first ambulation, ambulation without an assistive device, chronic osteomyelitis, and delayed amputation were not affected by the time to soft tissue coverage in Gustilo IIIB and IIIC fractures at our institution.
UNASSIGNED: We evaluated all patients treated for open tibia fractures at our institution from 2007 to 2017. Patients requiring any form of soft tissue coverage to the lower extremity during their initial hospitalization and who had at least 30 days of follow-up from time of hospital discharge were included. Univariable and multivariable analysis was performed for all variables and outcomes of interest.
UNASSIGNED: Of 575 patients included, 89 required soft tissue coverage. On multivariable analysis, the time to soft tissue coverage, length of negative pressure wound therapy treatment, and number of wound washouts were not found to be associated with development of chronic osteomyelitis, decreased 90-day return to any ambulation, decreased 180-day return to ambulation without assistive device, or delayed amputation.
UNASSIGNED: Time to soft tissue coverage in open tibia fractures did not affect time to first ambulation, ambulation without an assistive device, chronic osteomyelitis, or delayed amputation in this cohort. It remains difficult to definitively prove that time to soft tissue coverage meaningfully impacts lower extremity outcomes.