| Objective:To discuss the effective method to treat the disease， through thecomparison of the clinical efficacy of antibiotic bead implantation after vacuum sealingdrainage and antibiotic liquid lavage drainage in the treatment of Chronic Osteomyelitis.Methods: Between February2012and August2013，We study retrospectively42hospitalized cases of Chronic Osteomyelitis that come from Affiliated Hospital ofShandong University of Traditional Chinese Medicine with complete data.Among them，22cases (experimental group) were treated by antibiotic bead implantation after vacuumsealing drainage (VSD),and20cases (control group) by lavage drainage with continuousantibiotic liquid.All patients have undergone debridement before operation.After comparing the two treatment group in the cure rate, relapse rate, detection rateof bacteria,antibiotic use time, healing time, hospitalization time, and postoperativefunctional assessment etc, we discuss its efficacy in treatment of chronic osteomyelitis.We make the collected data into tables, using t test and X2test for statistical analysis.Results:After operation,42cases were followed up。The follow-up time was6months to3years,and the average time was18months. The experimental group:19caseswere cured,2cases markedly effective,1case effective。 The recovery of functionevaluation:18cases were excellent,3cases were good, and1case acceptable。controlgroup:11cases were cured,3cases markedly effective,2cases effective,4casesrecurrent。Recovery of function evaluation:10cases were excellent,4cases were good,4cases were acceptable,2cases bad。We analylized the data of the two groups about the curerate,relapse rate, re-debridement rate, detection rate of bacteria, antibiotic use time,healing time, hospitalization time,and postoperative functional evaluation。 After statisticalanalysis，the P-value was less than0.05，so statistical significance was proved。Conclusion:Through the statistical analysis of the two treatment groups, we foundthat VSD achieves to drain deep wound bacteria and necrotic tissue。This reduces thenumber of pathogens, tissue swelling, surface of wound, skinflap transplantation,andpromotes the regeneration of granulation tissue of wound. Not only does antibiotic beadimplantation maintain effective bactericidal concentration of lesion for a longer time andreduces the relapse rate, but also avoids the long-term use of systemicantibiotics. Thesimple antibiotic flushing is easy to plug tube, making drainage incomplete,and has ahigher recurrence。Also long-term application of antibiotics is easy to generate damage tothe body,and produce resistance, long-term catheter also increases the risk of crossinfection. The results showed that VSD combined with antibiotic heads chain implantationafter debridement is an ideal operation method in treatment of chronic osteomyelitisaffected by gram positive bacteria，especially an osteomyelitis with soft tissue defect。Theclinical efficacy is acknowledged, and worthy of promotion. |
