Lower Extremity Trauma: Trends in the Management of Soft-Tissue Reconstruction of Open Tibia-Fibula Fractures

Parrett, Brian M.; Matros, Evan; Pribaz, Julian J.; Orgill, Dennis P.

doi:10.1097/01.prs.0000204959.18136.36

Cited by 275 publications

(198 citation statements)

References 40 publications

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“…That period was 1997 to 2000 which abuts the 1997 FDA approval of negative pressure wound therapy. The infection rates were equivalent at 14% for gauze dressings and 15% for negative pressure wound therapy in their study [45]. The patients in the two studies [7,49] with decreased and the one [45] with equivalent infection rates and negative pressure wound therapy dressings all had wound closure within 7 days.…”

Section: Negative Pressure Wound Therapy and Infection Reduction In Gmentioning

confidence: 94%

“…Pediatric studies were not excluded. Thirteen studies remained [6,7,15,16,29,30,33,35,36,45,47,49,50] after reading the abstract and the full-length article as needed to ascertain data points. Twenty-two studies were eliminated from the final 35 articles identified because they were review articles (n = 8), articles regarding pilon fracture (n = 2), and articles with insufficient data or case reports (n = 12).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…All publications were from 2006 and later, likely owing to FDA approval in 1997 and several years thereafter for clinicians to use negative pressure wound therapy and several more years for patient followup. One of the 13 studies was an RCT [49], and the remaining 12 were retrospective [6,7,15,16,29,30,33,35,36,45,47,50]. The RCT was not eliminated because of lack of study quality as defined by Moher et al [37] or by Detsky et al [17].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…extended beyond 72 hours. Six studies [6,15,16,29,35,45] reported data on flap procedure rates when negative pressure wound therapy extended beyond 72 hours. For the purposes of this review, any patient treated with antibiotics alone or antibiotics and surgical incision and drainage or other procedure was considered to have an infection.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Use of negative pressure wound therapy in some centers extends long beyond the acute injury phase (weeks at a time with intermittent sponge changes). These centers have found an associated decreased rate of free or local flap procedures [6,15,16,29,35,45], and an increase in delayed primary closure or skin grafting. Whether the outcomes are as universally favorable for Grade IIIB tibia fractures needs to be determined.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Schlatterer

Hirschfeld

Webb

2015

Clinical Orthopaedics &Amp; Related Research

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Background Grade IIIB open tibia fractures are devastating injuries. Some clinicians advocate wound closure or stable muscle flap coverage within 72 hours to limit complications such as infection. Negative pressure wound therapy was approved by the FDA in 1997 and has become an adjunct for many surgeons in treating these fractures. Opinions vary regarding the extent to which negative pressure wound therapy contributes to limb salvage. Evidence-based practice guidelines are limited for use of negative pressure wound therapy in Grade IIIB tibia fractures. This systematic literature review of negative pressure wound therapy in Grade IIIB tibia fractures may substantiate current use and guide future studies. Questions/purposes We sought to answer the following:(1) Does the use of negative pressure would therapy compared with gauze dressings lead to fewer infections? (2) Does it allow flap procedures to be performed safely beyond 72 hours without increased infection rates? (3) Is it associated with fewer local or free flap procedures? Methods We conducted a systematic review of six large databases (through September 1, 2013) for studies reporting use of negative pressure wound therapy in Grade IIIB open tibia fractures, including information regarding infection rates and soft tissue reconstruction. The systematic review identified one randomized controlled trial and 12 retrospective studies: four studies compared infection rates between negative pressure wound therapy and gauze dressings, 10 addressed infection rates with extended use, and six reported on flap coverage rates in relation to negative pressure wound therapy use beyond 72 hours. None of the 13 studies was eliminated owing to lack of study quality.

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Section: Negative Pressure Wound Therapy and Infection Reduction In Gmentioning

confidence: 94%

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Schlatterer

Hirschfeld

Webb

2015

Clinical Orthopaedics &Amp; Related Research

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Experimental study of fat grafting under negative pressure for wounds with exposed bone

Kao

Hsu

Chuang

et al. 2015

British Journal of Surgery

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The combination of fat grafting and vacuum therapy represents a synergistic interaction of regenerative cells, hospitable wound matrix and stimulating micromechanical forces. It could accelerate complex wound healing through cell proliferation, neoangiogenesis and maturation of functional blood vessels. The efficacy of a multimodal wound healing approach is established in this experimental model; it could easily be translated into clinical trials of treatment for difficult wounds.

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Vascularized bone transfer for severe injury around the ankle

2009

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Severe injuries around the ankle are very difficult to treat. Although technically demanding, vascularized bone transfer has the potential to span bone defects, eradicate infection, and provide soft tissue coverage all in one stage. The fibula is the best choice for transfer as it produces the best results and the least donor site morbidity. Complications are reasonably common as in all complex reconstructive surgery, but in the properly selected patient this approach offers the best chance for salvage of a functional limb. The purpose of this review is to evaluate some of the various options available for managing severe injuries around the ankle with particular focus on vascularized bone grafts, particularly the vascularized fibular bone graft. Selection criteria, surgical timing, potential donor sites, as well as outcomes and possible complications are presented regarding the available options for vascularized bone grafts in managing severe ankle injuries.

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Lower Extremity Trauma: Trends in the Management of Soft-Tissue Reconstruction of Open Tibia-Fibula Fractures

Cited by 275 publications

References 40 publications

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

Experimental study of fat grafting under negative pressure for wounds with exposed bone

Vascularized bone transfer for severe injury around the ankle

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