[Clinical study on negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis].

OBJECTIVE: To study the clinical effects of negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis.

METHODS: From June 2013 to December 2016, there were 35 cases of chronic osteomyelitis patients in our department, including 23 males and 12 females, ranging in age from 11 to 65 years old, with an average of 34 years old. The course of disease ranged from 8 to 46 months, with an average of 26 months. All patients were chronic osteomyelitis caused by open wounds. The lesions had recurrent redness and swelling and purulent skin perforation. Thirty-two patients had positive results in bacterial culture of sinus secretions, and 3 patients had negative results. Imaging examination showed the lesions of bone destruction, bone defects, surrounded by bone hyperplasia sclerosis. At the first stage, complete debridement was performed to remove necrotic tissues and inflammatory tissues; and the dressing of negative pressure closed drainage was used to completely cover the wound so as to promote the repair of the wound. At the second stage, the vancomycin loaded, calcium sulfate and autogenous iliac cancellous bone were mixed into the bone graft complex to evenly fill the lesions. The healing of the wound was observed and X-ray examination of the lesion was carried out to observe the absorption of calcium sulfate and the growth of new bone.

RESULTS: Twenty-six patients underwent debridement and negative pressure closed drainage on time, 6 patients 2 times, and 3 patients 3 times. Thirty-two patients had incisions healed with grade A; 2 patients had incisions healed with grade B, and got completely healing after anti-infection, and wound dressing treatment; 1 patient had an incision healed with grade C, and got normal healing after re-debridement at the 4th week after operation. All patients did not have skin redness and ulceration again. X-ray imaging showed that the implanted calcium sulphate was absorbed gradually around 4 weeks, new bone was formed at 8 weeks, and bone defects in the lesions area were healed completely at 6 months to 2 years.

CONCLUSIONS: Negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis is a good and reliable method, worthy of clinical promotion.