Open Bone Grafting Combined With VSD In The Treatment Of The Chronic Osteomyelitis

objective:Introduce the method of open bone grafting combined with vacuum sealing drainage (VSD) in the treatment of chronic osteomyelitis, Contrast the curative effect of open bone grafting combined with VSD and bone grafting after infection controlled for the treatment of chronic osteomyelitis.Improve the curative effect. Methods:Retrospective study38cases of chronic osteomyelitis.A group of20cases of patients with chronic osteomyelitis, the treatment procedure included dressing change, debridement and external fixation. After the debridement, the one stage open bone grafting was performed with Autologous bone chips, which was less than5mm in diameter. VSD covered with the wound, sensitive antibiotics after surgery, the wound replaced VSD every5-10d, until the fresh granulation covered the wound, in some cases required two skin grafts. Group B,18patients first infection control, eradication of wound infection control after3-6months OK two graft treatment of bone defects. B group of18cases of patients with chronic osteomyelitis, The treatment procedure included controlling infection, eliminate wound infection, the bone grafting was performed3-6months later after The infection was controlled. Results:All the cases were followed up. Group A:The average follow-up duration11.5months (7-22months).2cases replace VSD only once,14cases replace VSD twice, three times in3cases,1 case of replacement of the VSD four times. the average time is2.15in one case. The average time of the wound covered by the fresh granulation tissue was31.55d (22-46d), The average time of using VSD after surgery was30d (23-46d). The wound direct suture in12cases,8cases use the skin grafting after good granulation. Two cases underwent twice skin grafting, the rest for once. The average time of the wound healing after skin grafting is16d(14-24d). Average bone healing time is6.55months (3-10M), The average time of except for the external fixation is8.5months (5-16months). Group B:The average follow-up duration13.4months (10-28M).3cases of debridement twice,4cases of debridement three times,9cases of debridement four times,2cases of debridement five times. the average3.56times per cases. The average time of the wound covered by the fresh granulation tissue was48.44d (38-65d),10cases direct suture,8cases applied flap technique. Average bone healing time is9.06months (5-14M). By comparing two sets of data and found that two groups have a similar situation in age,gender composition, preoperative course, the site of injury, cause of injury, skin defects and bone defects (Table1-6). However, Compared to the group B,the group A which have the lower time of granulation of covering and bone healing, the results show P<0.05(Table7-8). Conclusion:The open bone grafting combine with VSD is an optional therapy for chronic osteomyelitis.