Journal of Orthopaedics and Traumatology

, Volume 8, Issue 4, pp 173–176 | Cite as

Treatment of 78 type II and type IIIa open fractures by primary closure on suction drain: a prospective study

Original

Abstract

The purpose of this study was to assess if primary closure of wounds on a suction drain can be performed in open fractures after debridement and to determine the risk of infection and nonunion. A total of 78 type II and type IIIa open fractures were managed with primary closure on a suction drain. They were followed until union. Rates of infection, delayed union and nonunion were determined and compared with rates reported in the literature. Overall, 16 fractures (20.5%) were complicated with superficial infections and 8 fractures (10.2%) had deep infections. Delayed union was observed in 11 fractures (14.1%) and nonunion in 12 fractures (15.3%). Primary closure of a wound on a suction drain seems to cause no significant increase in rates of infection, nonunion or delayed union.

Key words

Open fractures Primary closure Suction drain 

References

  1. 1.
    Paul M, Brow MD (1997) A rational approach to the avoidance of infection in open wounds. Inst Course lectures. American Academy of Orthopaedic Surgeons, vol. XXVIGoogle Scholar
  2. 2.
    Weitz-Marshall AB, Bosse MJ (2002) Timing of closure of open fractures. J Am Acad Orthop Surg 10(6):379–384PubMedGoogle Scholar
  3. 3.
    Gustilo RB, Anderson JT (1976) Prevention of infection in treatment of 1025 open fractures of long bones: a retrospective and prospective study. J Bone Joint Surg Am 58:453–458PubMedGoogle Scholar
  4. 4.
    Koval KJ, Meadows SE, Rosen H, Silver L, Zuckerman JD (1992) Post-traumatic tibial osteomyelitis: comparison of three treatment approaches. Orthopaedics 15(4):455–460Google Scholar
  5. 5.
    Olson SA (2005) Open fractures. In: Bucholz RW, Heckman JD, Court-Brown CM (eds) Rockwood and Green’s fractures in adults, 5th edn. Wolters Kluwer, Philadelphia, pp 286–316Google Scholar
  6. 6.
    Nuzumlali ME, Kose H, Demirel D (1993) Primary closure of gunshot wounds caused by high velocity rifles. Mil Med 158(8):563–565PubMedGoogle Scholar
  7. 7.
    Benson DR, Riggins RS, Lawrence RM, Hoeprich PD, Huston AC, Harrison JA (1983) Treatment of open fractures: a prospective study. J Trauma 23(1):25–30PubMedCrossRefGoogle Scholar
  8. 8.
    DeLong WG Jr, Born CT, Wei SY, Petrik ME, Ponzio R, Schwab CW (1999) Aggressive treatment of 119 open fracture wounds. J Trauma 46(6):1049–1054PubMedCrossRefGoogle Scholar
  9. 9.
    Henley MB, Chapman JR (1998) Treatment of type II, IIIa, IIIb open fractures of tibial shaft: a prospective comparison of undreamed interlocking intramedullary nails and half pin external fixaters. Orthop Trauma 12(1):1–7Google Scholar
  10. 10.
    Merritt K (1988) Factors increasing risk of infection in patients with open fractures. J Trauma 28:823–827PubMedCrossRefGoogle Scholar
  11. 11.
    Fisher MD, Gustilo RB (1991) The timing of flap coverage, bone grafting and intramedullary nailing in patients who have open tibia fracture with extensive soft tissue injury. J Bone Joint Surg Am 73:1316–1320Google Scholar
  12. 12.
    Haung J, Yao YJ, Huang XK (2003) Treatment of open fractures by vacuum sealing technique and internal fixation. Zhongguo Xio Fu Chong Jian Wai Ke Za Zhi 17(6):456–458 (article in Chinese)Google Scholar
  13. 13.
    Venturi ML, Altinger CF, Mesbaki AN, Hess CL, Graw KS (2005) Mechanism and clinical application of vacuum assisted closure device: review. Am J Clin Dermatol 6(3):185–194PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery Physical Medicine and RehabilitationPt. B.D. Sharma Post Graduate Institute of Medical SciencesRohtakIndia

Personalised recommendations