The effect of wound closure timing on fracture healing in an open fracture model in diabetic rats.

Project no. 20398 · Status: Kapanmış (Yayın bekleniyor) · 2019

Summary

The optimal timing of wound closure with regard to soft tissue defects after tibial open fractures is still debated. Factors such as impaired fracture healing and impaired wound healing, especially in diabetic patients, complicate the management of these fractures. In our study, it was aimed to compare the effect of wound closure at 24 or 72 hours, on fracture healing and infection rates in normal and diabetic rat groups by creating a type 3B open fracture model on rat tibias. In all subjects, wound closure was achieved by applying a medial gastrocnemius muscle flap at 24 or 72 hours after tibial middle diaphyseal osteotomy and periosteal stripping, according to the group. At the twelfth week after sacrification, subjects were evaluated by morphological, radiological, histological, biomechanical, and micro-computed tomography assessment. In diabetic subjects, although a better radiological union mean rank (p=0.374) and a lower infection rate (p=0.599) were observed in the 24-hour flap group compared to the 72-hour group, this difference could not be shown statistically. In normal subjects, a significantly better mean rank of radiological union (p=0.045), a statistically significant lower fistula-abscess ratio (p=0.033), and a better histological bridging ratio were observed in the 24-hour flap group than in the 72-hour group. Stiffness, BMD, TMD, BV/TV and Conn.#/TV values showing better bone union were also observed better in the 24-hour group, but they were not statistically significant (p=0.625, p=0.31, p=0.256, p =0.259, p=0.255). In conclusion, after tibial type 3B open fractures, wound closure within 24 hours may provide better fracture healing and a lower infection rate than closure within 72 hours in the healthy or diabetic population.Key words: tibia, open fracture, type 3B, diabetic, rat, wound closure time, flap

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