족부 및 족관절의 개방성 골절 환자에서 음압 치료와 실버 드레싱 제재 복합 치료의 유용성 (The Effectiveness of Vacuum-Assisted Closure (V.A.C) Dressing combined with Silver Dressing Material in Open Fracture of the Foot and Ankle)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 12권 / 2호 / 156 ~ 162페이지
· 저자명 : 이유상, 조재호, 박진, 한승환

초록

Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy,
insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet
general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum-
Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together
with silver antimicrobial dressing materials in contaminated open fracture wounds.
Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle
treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between
duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed.
Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver
dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship
was found between wound size, VAC application time and silver dressing material application time. No complications such
as osteomyelitis were found after treatment.
Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good
results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC
technique together with silver dressing materials in the treatment of open fractures and achieved complication free
results.

영어초록

Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy,
insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet
general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum-
Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together
with silver antimicrobial dressing materials in contaminated open fracture wounds.
Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle
treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between
duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed.
Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver
dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship
was found between wound size, VAC application time and silver dressing material application time. No complications such
as osteomyelitis were found after treatment.
Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good
results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC
technique together with silver dressing materials in the treatment of open fractures and achieved complication free
results.

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