EVALUATION OF CLINICAL OUTCOME OF NEGATIVE PRESSURE WOUND THERAPY IN GUSTILO ANDERSON TYPE IIIA/IIIB OPEN FRACTURES OF EXTREMITIES

Abstract

Background: Open-fractures are a common and serious injury that primarily affects young males. Enhancement in fracture management was noticed in the last decade. However, an infection with its complications still a concern, especially in case of open fractures for primary closure of the injured area. Newer technique called Vacuum Assisted therapy has become a therapy of choice for many orthopaedic surgeons. Aim and Objective: To determine whether Vacuum Assisted closure reduces the duration of wound healing along with declines in frequency of infections after fixation of Gustilo Anderson Type IIIA/ IIIB fractures of the extremities. Methodology: An observational and analytical study was conducted among 34 samples presented with Gustilo Anderson Type IIIA/ IIIB fractures of the limbs presented to department of Orthopaedics, R. L. Jalappa hospital, Kolar from December 2019 to July 2021. Negative-pressure wound therapy for closure of wound after fixation of fractures. Patients were followed up for one month. The outcomes of the intervention are presented both in tables and diagrams. Results: The mean age of the contemporary data samples was 37.06 ± 10.340 years. The prevalence of infection before Vacuum-assisted closure dressing was 80.6% and the prevalence of infection after Vacuum-assisted closure dressing was 19.4%. The difference in ``xix proportion beforehand vs subsequently the intervention is statistically significant (p < 0.001) according to the McNemar Test. Hence Vacuum-assisted closure dressing benefits to decrease the rate of infection. The mean dimension of wound before Vacuum-assisted closure therapy was 66.05cm2 and the mean dimension of wound after Vacuum-assisted closure therapy was 27.97cm2. The difference in mean before and after the intervention is found to be statistically significant according to the Paired T Test (p < 0.001). Hence, Vacuum-assisted closure dressing helps to decrease the wound size and it was proved statistically. Conclusion: Vacuum-assisted closure treatment is a viable and beneficial treatment option for complicated fractures with large soft-tissue abnormalities.