ABSTRACT
Objective To explore the therapeutic effect of epluchage combined with vacuum sealing drainage and topical oxygen therapy in the treatment of chronic bone exposed wounds.Methods Thirty-two patients with chronic bone exposed wounds were enrolled in this study from December 2014 to January 2017.All these patients were treated by epluchage combined with vacuum sealing drainage and topical oxygen therapy.Observed the growth and healing time,bacteriology changes,and related preoperative imaging studies of the wounds.Results The X-ray examination showed that there were 14 cases of decrease of the local bone density,disappearance of normal bone structure,and thickening of the outer membrane;10 patients with local defects of bone cortex and cancellous;4 cases of bone density increase;and 4 cases of periosteal reaction with different degree and unclear bone tissue damage.After epluchage combined with vacuum sealing drainage and topical oxygen therapy,granulation tissue of all the 32 cases grew rapidly,and the bone exposure areas were quickly covered.Wound secretions and exudate were significantly reduced,and the wounds were crued after several dressing change,without any postoperative infection.The healing time was 16 to 30 days,with the average time of (23.6±3.6)days.After being followed-up for 6 to 12 months,it was showed that the wound healed well without ulceration and recurrence.Secretions examination showed that there were 20 cases of secretions bacterial cultured to negative,while there were 6 cases of staphylococcus aureus and 6 cases of staphylococcus epidermidis.Conclusion On the basis of definite lesion range,remove the lesions dead bone through epluchage and cure the chronic bone exposed wounds with postoperative vacuum sealing drainage and topical oxygen therapy can significantly shorten the wound healing time and avoid recurrence.