Recovery of the skin is the most important task during the treatment of open fractures of the tibia, as prevents the development of suppuration in the wound and helps to reduce the duration of the symphysis fractures. In patients with double open fractures of the tibia primary skin grafting is of particular importance because of the severity of damage.
Such fractures usually occur during transport and industrial injuries and are accompanied by compression of the limb with extensive skin lesions in pokorney tissue and muscles.
The aim of this study was to clarify the indications for various types of skin plasty, clarification of the nature and number of complications arise and comparative evaluation of applied methods skin autoplastic. Under medical supervision, there were about 70 patients with open double fracture of the tibia, of these, 22 (31,4) produced a primary skin grafting.
Men 17, women — 5, age — 17 years to 74 years. 20 patients were injured due to traffic accidents, 2 patients — in production as a result of falls from height. In 19 patients the fractures were very heavy 3B—4 type, 3 people fractures type 2B (according to the classification of academician V. A. Kaplan, O. N. Markova).
During the implementation of measures for primary surgical treatment open double fracture of the tibia, we used the following methodology plasty with local tissues when cutting out flaps, laxative incisions (13 patients) reimplantation extensive delamination of skin flaps by Krasavitsa (5 patients) free dermatomal plastic surgery skin split graft (4 patients).
Plastic local fabrics considered are shown, if after excision wounds convergence of its edges without tension failed, but the damage and detachment of the skin for a considerable distance around the wound was not. In this situation tried to include displaced flap in the subcutaneous material clutched and muscles to fill the wound bed.
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