Stručni rad
Treatment of Hardware Infection after Osteosynthesis of Lower Leg using Negative Pressure Wound Therapy and Transforming Powder Dressing
Marin Marinović
; Department of Surgery, University Hospital of Rijeka, Rijeka, Croatia
Aldo Ivančić
; Department of Surgery, University Hospital of Rijeka, Rijeka, Croatia
Josip Španjol
; Department of Urology, University Hospital of Rijeka, Rijeka, Croatia
Maja Pin
; Faculty of Medicine, University of Rijeka, Rijeka, Croatia
Bore Bakota
; Department of Traumatology, General Hospital of Karlovac, Karlovac, Croatia
Ante Bandalović
; Department of Surgery, University Hospital of Split, Split, Croatia
Fabijan Čukelj
; Department of Surgery, University Hospital of Split, Split, Croatia
Sažetak
Fractures of the distal part of the lower leg are more common in everyday practice and traumatology. In young and
active patients these injuries are mainly caused by high energy trauma. They are treated with external fi xator in fi rst step,
and in second step, after sanation of the soft tissue, with open reduction and internal fi xation (ORIF). It is very safe and
effective method of treatment. Treatment of the infections that occur in the early postoperative period after open reduction
and internal fi xation represents a great problem and challenge for surgeons. It is widely accepted that the presence of deep
infection can´t be cured in the presence of hardware. However, removal of hardware in the presence of unhealed fractures
signifi cantly complicates sanation of infection and fracture itself. We have decided to present a 35-years-old patient with
a hardware infection with present chronic wound with hardware exposed eight months after the fi rst operation and six
months after second operation. The wound measured one centimeter in diameter with cell detritus and bad granulations
tissue inside the wound. Hardwre was exposed in the depth of the wound.The secretion was minimal. Negative Pressure
Wound Therapy (NPWT) was applicated after debridemet and lavage performed in ambulatory conditions. The starting
therapy was continuously –125 mm Hg of vacuum. After fi ve days of NPWT the defect was partially fi lled with granulation
tissue. For another fi ve days we continue with NPWT with the same values of –125 mm Hg pressure but in the intermitent
mode. After that period we used transforming powder dressing for covering and protection of the wound with was
fi lled with granulation tissue. Five days later, wound was completely healed with epithelisation. After four months of
patient follow-up, we found the wound is completely repaired. The patient denies pain and has continued orderly fl ow of
fracture healing, with no signs of infection.
Ključne riječi
hardware infection; NPWT; transforming powder dressing; lower leg fracture
Hrčak ID:
147444
URI
Datum izdavanja:
26.12.2014.
Posjeta: 666 *