Introducing Negative Pressure Wound Therapy for Lower Limb Defects: A Report of Three Cases of Open Fractures Fixed with Ilizarov External Fixator

Abstract

The Ilizarov external fixator fixes the ring frame to the bone using steel wires and pins, then connects the plurality with rods. It enables stronger fixation and adjustment in various angles and directions than that by other modular external fixators. It is often used for damage control and reduction fixation of open fractures, but there are difficulties in handling necrotic skin and soft tissue over time. In particular, when the bone is exposed, it is recommended to cover it with a flap or skin graft as soon as possible. However, in cases of a wound surrounded by an Ilizarov external fixator, flap plasty would be challenging due to the large number of steel wires and pins inserted. Therefore, the wound needs to be carefully managed until it is closed.We report three cases of lower limb open fractures with tissue defect, in which negative pressure wound therapy was introduced simultaneously with fixation using the Ilizarov external fixator and proper wound management.