Simple external skin expansion technique in treatment of skin necrosis defect after the surgery for Pilon fracture / 天津医药

ABSTRACT

Objective To evaluate the clinical effects of simple external skin expansion technique in treatment of skin necrosis defect after the surgery for Pilon fracture.Methods Data of 12 patients with skin necrosis defect after the surgery for Pilon fracture treated with simple external skin expansion technique in our hospital from May 2015 to January 2017 were retrospectively analyzed.There were 10 males and 2 females in the 12 patients with age 32-58 years old(average 45.30± 8.91 years old).There were 4 cases with open fractures and 8 cases with closed fractures.The defect area was about 9.1 cm long and 3.9 cm wide.There were 3 cases with skin necrosis of open fractures and 9 cases with postoperative skin necrosis of incision site. After completely debridement and removing infection from the skin necrosis areas, kirschner needle wired intermittented through the skin,the kirschner wire was around a sterile silicone rubber tube at both ends and the kirschner wire was connected to the both ends of the Kirschner on the opposite side.After giving moderate tensile force,which showed that the skin on both sides was still bleeding,no obvious pale color on skin,two ends of rubber tube were fixed with forceps. Using the ductility of skin and the tensile force of sterile silicone rubber tube to gradually extend the skin and to gradually narrow and close the suturing wound.All patients were followed up for 3-6 months to observe the effect of surgery.Results All of the 12 cases were healed in 2-4 weeks,average(2.50±0.59)weeks.The patients were sutured directly after simple external skin expansion,and 4 patients were sutured with the surface of the external plate or tendon,and parts of wound were delayed healed after the re-suture.The skin color,lustre,hair growth and elasticity were normal,no bloated,and tenderness was normal after simple external skin expansion.Conclusion The simple external skin expansion technique in treatment of skin necrosis defect after the surgery for Pilon fracture is a simple,effective and economic method,which is worthy of clinical promotion.