Objective To evaluate the efficacy of skin traction combined with hyperbaric oxygen (HBO) in the treatment of skin defects in crus. Methods Thirty-six patients with skin defects in crus admitted into the trauma department of Yantaishan hospital from August 2010 to April 2018, were treated with external fixation device and skin tractor produced by the Beijing Orthopedic Research Institute. Skin traction was performed after the margin of skin necrosis was clearly identified, and the external fixation device for skin traction was properly placed. From the first day after surgery, the traction ring or the tractor connecting rod was moved forward 1mm a day in the direction of skin defect, the procedures of which were divided into 6 times. The patients were randomly divided into 2 groups: the routine group (n=19) and the hyperbaric oxygen group (n=17). The following day after surgery, HBO therapy was implemented. Results Of the 17 patients who received skin traction combined with HBO in the HBO group, there was no case of infection and complications. However, of the 19 patients with routine treatment, there were 4 cases of infection, of which 1 case was seriously infected. Skin traction was momentarily suspended and sensitive antibiotics was applied, and 1 week after treatment, infection was controlled and skin traction continued. In the HBO group, there was 1 case of needle out-cut by Kirschner needle, while there were 7 cases in the routine group, of which 3 cases healed after debridement and suture and other 4 cases were treated with secondary skin traction. Conclusion Skin traction combined with HBO in the treatment of skin defects in crus could significantly reduce the loosening of nails and the rate of needle out-cut, and the rate of soft tissue infection as well.
Chinese Journal of Nautical Medicine and Hyperbaric Medicine