Skip to main content

Official Journal of the Italian Society of Orthopaedics and Traumatology

  • Original
  • Published:

Treatment of 78 type II and type IIIa open fractures by primary closure on suction drain: a prospective study


The purpose of this study was to assess if primary closure of wounds on a suction drain can be performed in open fractures after debridement and to determine the risk of infection and nonunion. A total of 78 type II and type IIIa open fractures were managed with primary closure on a suction drain. They were followed until union. Rates of infection, delayed union and nonunion were determined and compared with rates reported in the literature. Overall, 16 fractures (20.5%) were complicated with superficial infections and 8 fractures (10.2%) had deep infections. Delayed union was observed in 11 fractures (14.1%) and nonunion in 12 fractures (15.3%). Primary closure of a wound on a suction drain seems to cause no significant increase in rates of infection, nonunion or delayed union.


  1. Paul M, Brow MD (1997) A rational approach to the avoidance of infection in open wounds. Inst Course lectures. American Academy of Orthopaedic Surgeons, vol. XXVI

  2. Weitz-Marshall AB, Bosse MJ (2002) Timing of closure of open fractures. J Am Acad Orthop Surg 10(6):379–384

    PubMed  Google Scholar 

  3. Gustilo RB, Anderson JT (1976) Prevention of infection in treatment of 1025 open fractures of long bones: a retrospective and prospective study. J Bone Joint Surg Am 58:453–458

    CAS  PubMed  Google Scholar 

  4. Koval KJ, Meadows SE, Rosen H, Silver L, Zuckerman JD (1992) Post-traumatic tibial osteomyelitis: comparison of three treatment approaches. Orthopaedics 15(4):455–460

    CAS  Google Scholar 

  5. Olson SA (2005) Open fractures. In: Bucholz RW, Heckman JD, Court-Brown CM (eds) Rockwood and Green’s fractures in adults, 5th edn. Wolters Kluwer, Philadelphia, pp 286–316

    Google Scholar 

  6. Nuzumlali ME, Kose H, Demirel D (1993) Primary closure of gunshot wounds caused by high velocity rifles. Mil Med 158(8):563–565

    CAS  PubMed  Google Scholar 

  7. Benson DR, Riggins RS, Lawrence RM, Hoeprich PD, Huston AC, Harrison JA (1983) Treatment of open fractures: a prospective study. J Trauma 23(1):25–30

    Article  CAS  PubMed  Google Scholar 

  8. DeLong WG Jr, Born CT, Wei SY, Petrik ME, Ponzio R, Schwab CW (1999) Aggressive treatment of 119 open fracture wounds. J Trauma 46(6):1049–1054

    Article  PubMed  Google Scholar 

  9. Henley MB, Chapman JR (1998) Treatment of type II, IIIa, IIIb open fractures of tibial shaft: a prospective comparison of undreamed interlocking intramedullary nails and half pin external fixaters. Orthop Trauma 12(1):1–7

    CAS  Google Scholar 

  10. Merritt K (1988) Factors increasing risk of infection in patients with open fractures. J Trauma 28:823–827

    Article  CAS  PubMed  Google Scholar 

  11. Fisher MD, Gustilo RB (1991) The timing of flap coverage, bone grafting and intramedullary nailing in patients who have open tibia fracture with extensive soft tissue injury. J Bone Joint Surg Am 73:1316–1320

    Google Scholar 

  12. Haung J, Yao YJ, Huang XK (2003) Treatment of open fractures by vacuum sealing technique and internal fixation. Zhongguo Xio Fu Chong Jian Wai Ke Za Zhi 17(6):456–458 (article in Chinese)

    Google Scholar 

  13. Venturi ML, Altinger CF, Mesbaki AN, Hess CL, Graw KS (2005) Mechanism and clinical application of vacuum assisted closure device: review. Am J Clin Dermatol 6(3):185–194

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to R. Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siwach, R., Singh, R., Arya, S. et al. Treatment of 78 type II and type IIIa open fractures by primary closure on suction drain: a prospective study. J Orthopaed Traumatol 8, 173–176 (2007).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Key words