“3P” therapy versus traditional debridement therapy for open fractures of the extremities

doi:10.3969/j.issn.2095-4344.2015.51.028

Abstract

Abstract:

BACKGROUND: Versajet hydrosurgery system combined with silver ion dressings and negative pressure wound therapy in the treatment of Gustilo II and III open fractures of the extremities is known as “3P” therapy.
OBJECTIVE: To explore the therapeutic effects of “3P” therapy versus traditional debridement therapy in the treatment of open fractures of the extremities.
METHODS: Thirty patients with open fractures of the extremities admitted at the First Affiliated Hospital of Xinjiang Medical University, China were selected, and randomized into “3P” therapy group (test group) and traditional debridement therapy group (control group). Counting of white blood cells, C-reactive protein, bacterial culture and drug sensitivity and the degree of pain were compared between two groups.
RESULTS AND CONCLUSION: At 1, 3, 5, 7 days after treatment, the number of white blood cells in the test group was significantly lower than that in the control group. At 1 and 7 days after treatment, the expression of C-reactive protein was significantly higher in the control group than the test group. Results from bacterial culture and drug sensitivity tests showed that “3P” therapy could effectively inhibit bacterial growth. Pain score in the test group was significantly lower than that in the control group at 7 days after treatment (P < 0.05). These findings indicate that Versajet hydrosurgery system combined with silver ion dressings and negative pressure wound therapy in the treatment of Gustilo II and III open fractures of the extremities can effectively fight against inflammation and bacterial growth, and reduce the pain of patients during dressing change.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

CLC Number:

R318

Ma Chao, Zhao Yan, Qiao Wan-qing, Shao Dong-dong, Ma Le-yuan, Ma Ya-li . “3P” therapy versus traditional debridement therapy for open fractures of the extremities[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(51): 8359-8364.

Figures/Tables 5

References

[1] Konda SR, Davidovitch RI, Egol KA.Open Knee Joint Injuries. Bull Hosp Jt Dis.2014;72(1): 61-9.

[2] 徐永清,范新宇.重视伤情判断，探讨四大争议——再谈开放性骨折的诊断,处理和治疗[J].中华创伤骨科杂志,2014,16(11): 921-924.

[3] Gustilo RB, Merkow RL,Templeman D. The management of open fractures. J Bone Joint Surg Am.1990; 72: 299-304.

[4] Giannoudis PV, Papakostidis C, Roberts C. A review of the management of open fractures of the tibia and femur. J Bone Joint Surg Br.2006;88: 281-289.

[5] Keen JS, Desai PP, Smith CS,et al. Effiacy of hydrosurgical debridement and nanocrystalline silver dressings for infection prevention in type II and III open injuries. Int Wound J.2012;9: 7-13.

[6] Crowley DJ, Kanakaris NK, Giannoudis PV. Debridement and wound closure of open fractures: the impact of the time factor on infection rates. Injury.2007; 38: 879-889.

[7] Weitz-Marshall AD, Bosse MJ. Timing of closure of open fractures.J Am Acad Orthop Surg.2002; 10: 379-384.

[8] Caputo WJ, Beggs DJ, DeFede JL, et al. A prospective randomised controlled clinical trial comparing hydrosurgery debridement with conventional surgical debridement in lower extremity ulcers. Int Wound J.2001;5:288-294.

[9] Cubison TC, Pape SA, Jeffery SL.Dermal preservation using the Versajet hydrosurgery system for debridement of paediatric burns. Burns.2006;32:714-720.

[10] Gravante G, Delogu D, Esposito G,et al. Versajet hydrosurgery versus classic escharectomy for burn de´bridement: a prospective randomized trial. J Burn Care Res.2007;28:720-724.

[11] Vanwijck R, Kaba L, Boland S,et al.Immediate skin grafting of sub-acute and chronic wounds debrided by hydrosurgery. J Plast Reconstr Aesthet Surg. 2010;63:544-549.

[12] Bibbo C, Brueggeman J. Prevention and management of complications arising from external fixation pin sites. J Foot Ankle Surg. 2010;49:87-92.

[13] 陈念平,陈明,缪辉来,等.不同切肝术的对比研究[J].中国基层医药杂志,2004,11(8):915-916.

[14] 丁华荣,张宪发,梁自乾,等.纳米银与磺胺嘧啶银治疗烧伤创面疗效比较的Meta分析[J].中国组织工程研究,2012,16(16): 2967-2970.

[15] Gristock R.Silver dressings:the need for clarity.J Wound Care.2005;14(1):30.

[16] Luo G,Tang J,He W,et al.Antibacterial effect of dressings containing multivalent silver ion carried by zirconium phosphate on experimental rat burn wounds.Wound Repair Regen.2008;16(6):800-804.

[17] Li J,Yan W,Jing L,et al.Addition of an alginate to a modified zeolite improves hemostatic performance in a swine model of lethal groin injury. J Trauma.2009;66(3):612-620.

[18] Wilkinson LJ,White RJ,Chipman JK.et al.Silver and nanoparticles of silver in wound dressings: a review of efficacy and safety.J Wound Care. 2011;20(11):543-549.

[19] Percival SL,Thomas J,Linton S,et al.The antimicrobial efficacy of silver on antibiotic-resistant bacteria isolated from burn wounds. Int Wound J.2012;9(5):488-493.

[20] Belcaro G,Cesarone MR,Errichi BM,et al.Silver oxide ointment wound dressing in venous ulcerations: home,self- management.Panminerva Med.2011;53(3 Suppl 1):29-33.

[21] 王亦璁.骨与关节损伤[M].4版.北京:人民卫生出版社,2007: 208-209．

[22] 裘华德,王彦峰,负压封闭引流技术介绍[J].中国实用外科杂志, 1998,18(4):233．

[23] Liu J, Ko JH, Secretov E,et al.Galiano RD1Comparing the hydrosurgery system to conventional debridement techniques for the treatment of delayedhealing wounds: a prospective, randomised clinical trial to investigate clinical efficacy and cost-effectiveness.Int Wound J.2015;12(4):456-461.

[24] Sainsbury DCG. Evaluation of the quality and cost-effectiveness of Versajet hydrosurgery. Int Wound J. 2009;6:24-29.

[25] Liu T, Xu HD. Silver ion dressing effects on healing of chronic wound. Zhongguo Zuzhi Gongcheng Yanjiu. 2013;17(42): 7494-7500.