探讨皮瓣联合负压封闭引流(VSD)及灌洗引流治疗胫骨骨折术后钢板外露的临床效果。

2012年1月至2022年6月，对乐山市人民医院美容整形烧伤外科及武警四川省总队医院烧伤整形外科收治的12例胫骨骨折钢板外露患者进行手术清创、VSD引流、灌洗引流等治疗，根据创面情况选择合适的皮瓣(肌瓣、肌皮瓣和轴型皮瓣)进行创面修复，术后同时予以创面持续灌洗引流等治疗。术后定期随访，复查X线片，骨折临床愈合后取出内固定。

12例患者皮瓣(肌瓣、肌皮瓣和轴型皮瓣)全部成活，创面封闭，感染控制。12例患者均获得随访，随访时间4~18个月，所有患者钢板均保留至骨折临床愈合并取出，骨折愈合，功能恢复良好。

对于胫骨骨折内固定术后钢板外露患者，采用皮瓣联合VSD、创面持续灌洗引流的治疗方法，可以同时达到保留内固定、骨折临床愈合及修复创面的目的。

To investigate the clinical effect of flap combined with vacuum sealing drainage, lavage and drainage in the treatment of plate exposure after internal fixation of tibial fracture.

From January 2012 to June 2022, 12 patients with tibial fracture and postoperative plate exposure were treated with surgical debridement combined with vacuum sealing drainage, continuous lavage and drainage in Department of Cosmetic Burn and Plastic Surgery, the People′s Hospital of Leshan and in Department of Burn Plastic Surgery, Sichuan Provincial Corps Hospital of Armed Police, and appropriate type of flap repairment (muscle, myocutaneous or axial pattern skin flap) in accordance with wound condition. Regular postoperative follow-up were conducted, along with regular X-ray review. Removed the internal fixation after clinical fracture healing.

All 12 patients had viable flaps (muscle, myocutaneous and axial pattern skin flap), closed wounds and controlled infection condition. All patients were followed up for 4-18 months. The plates were retained during the whole treatment duration until the fracture healed with full functional recovery.

In patients with exposed plates after internal fixation of tibial fractures, the combination treatment method of flap with vacuum sealing drainage, continuous lavage and drainage has advantages in retaining the internal fixation during the fracture healing, leading to wound repairment and full functional recovery at the same time.