Management of open fractures of the lower extremity how vacuum sealing technique and external fixation affect the outcome

Amputation has been the main stay of treating open fractures up to the middle of the 19™ century. This had resulted in considerable disability and great missery, especially in developing countries in terms of poor rehabilitation, and problems of prosthesis procurement. High infection rate, prolonged healing times and hospital stay, have greately hindered a normal life in victims with severe open fractures. Technology development in the western community today has tremendously revolutionized open fracture treatment not only from amputation to limb salvage but also development of methods which prevent or lower infection rate, achieve short healing time short, duration of hospital stay, as well as short occupational re-intergration time. Among 116 patients studied at the Traumatology department of the University of Ulm Germany, about 90% were treated by serial vacuum sealing after standard and serial debridement with thorough irrigation. Prophylactic antibiotic (cefuroxime) was administered to all patients and external fixation