Abstract
We performed preoperative negative-pressure wound therapy (NPWT) on 19 patients among 34 patients (35 flaps) with severe trauma to the extremities who presented between March 2009 and October 2013. These 19 patients consisted of 12 males (aged 10-75 years) and 7 females (aged 22-77 years). Their traumas comprised 13 Gustilo IIIB fractures, 5 Gustilo IIIC fractures, and one case of massive skin and soft tissue injury. The duration of NPWT was 5-10 days for 6 patients, 11-20 days for 9 patients, and 21-51 days for 4 patients. In the 2 most recent patients, we changed the external skeletal fixation method to intramedullary nail fixation when changing the NPWT system before reconstruction. Complications included total necrosis, partial necrosis, and deep infection in one patient each. Infection can be prevented by managing the trauma and by preparing for reconstructive surgery in a closed state. This procedure also allows for almost the same outcomes in subacute to late-stage reconstruction as those seen in early-stage reconstruction.
