Circumferential Negative Pressure Wound Therapy with Instillation and Dwell Prior to Delayed Flap Coverage for a Type IIIB Open Tibia Fracture

Abstract

Gustilo and Anderson type IIIB open tibia fractures are associated with high rates of surgical site infection, wound complications, and flap failure. Controversy surrounds the optimal timing and method of wound management prior to flap coverage. No studies to date have investigated the use of negative pressure wound therapy with instillation and dwell for open type IIIB tibia fractures. We present a single case of an open type IIIB tibia fracture that was managed with 21 days of circumferentially applied negative pressure wound therapy with instillation and dwell prior to flap coverage. Our results suggest that negative pressure wound therapy with instillation and dwell may minimize infection risk, decrease wound size, and allow for delayed soft tissue coverage.