Aim

Negative pressure wound treatment (NPWT) has been widely adopted in the management of septic wound complications or prophylactically after large surgeries. Recent publications have indicated the necessity of further investigations to support the use of NPWT with more evidences. Therefore, the purpose of this pilot-study was to investigate the efficacy of VAC-assisted dressing systems in the treatment of septic trauma cases.

Introduction: Displaced fractures of the pelvic ring represents challenge for the trauma surgeon.

Patients: From January 1999 to December 2006, the treatment was given to 134 patients (81 males, 53 females, aged 18–73 years) with pelvic ring fracture and dislocation. According to the AO (1988) classification, B type were 95, C type were 39 in cases.

Surgical technique: Closed reduction and retention of unstable pelvic injuries (type B and C injuries), in order to restore the form and function of the posterior pelvis by percutaneous iliosacral screw and when is necessary antegrad screw fixation of the anterior pelvic ring osteosynthesis, using conventional fluoroscopy. 134 patients with a posterior pelvic fracture or fracture dislocation underwent screw fixation with fluoroscopy with 8.0-mm, or 9.0 mm cannulated screws, placed in a transiliosacral position in the vertebral body of SI, and S II. Among these patient, 71 fixed with percutaneuos screw in the anterior pelvic ring fracture too.

Results: The average operating time was 23 min, the average screening time 2,11 min. Iatrogenic nerve damage was not found. All fractures healed within 3 months. 17% of the patients had residual pain, which were permanent or intermittent. Partly the reason could be the SI arthrosis, as we can see in 13% of the patients, or the fracture healing caused foramen stricture. Unfortunately we have lost 11 patients.

The Majeed functional scoring was applied. In conclusion we could say that 81% of our patients were in the excellent and good category.

Conclusions: The technique of percutaneous cannulated screws internal fixtion for treating the posterior and anterior portion of the pelvis has the advantages of small trauma, less bleeding stiff fixtion, which is an ideal and minimally invasive technique.