Journal of Japanese Society of Reconstructive Microsurgery
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
Original Article
Transition in the Management of Severe Open Fractures of the Lower Limb
Yuta HAYASHIRikuo SHINOMIYAAkira KODAMAToru SUNAGAWANobuo ADACHI
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2020 Volume 33 Issue 3 Pages 135-139

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Abstract

Introduction: The Trauma Research Group was established in 2017 in our region, and a novel concept emphasizing early transfer to a specialty center and early reconstruction was discussed for the management of open limb fractures. This study evaluated the impact of this novel concept for the management of severe open fractures on the clinical outcomes in our department.
Methods: Twenty-eight patients who underwent soft tissue reconstruction for a GustiloⅢb lower limb fracture were retrospectively investigated. We divided the patients into two groups: the previous (P) -group consisting of patients treated between 2011 and 2016, and the recent (R) -group consisting of patients treated between 2017 and 2019. We compared the clinical results between the two groups.
Results: The period from injury to first surgery in our department was significantly shorter in the R-group. The positive rate of bacterial tissue culture from affected cancellous bone was significantly lower in the R-group. Free vascularized bone graft (FVBG) and vein graft were required more frequently during reconstructive surgery in the P-group.
Conclusion: The early transfer and satisfactory management of GustiloⅢb lower limb fractures resulted in a lower infection rate and lower rate of invasive surgery such as FVBG and vein grafting.

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© 2020 Japanese Society of Reconstructive Microsurgery
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