日本マイクロサージャリー学会会誌
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
原著
重度下肢開放骨折に対する治療概念の変遷と臨床経過の変化
林 悠太四宮 陸雄兒玉 祥砂川 融安達 伸生
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ジャーナル 認証あり

2020 年 33 巻 3 号 p. 135-139

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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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