Abstract:

BACKGROUND: The wounds of large-area skin defect are difficult to repair, deep dead space is often associated with necrosis infection, thus the repair is difficult, the treatment is long and expensive. Vacuum sealing drainage technique has been widely used in clinic to repair all kinds of wounds.
OBJECTIVE: To evaluate the application of biomaterials and vacuum sealing drainage technique in a large area of skin and soft tissue defects combined with stealth dead space.
METHODS: A total of 32 patients with stealth dead space combined a large area of skin and soft tissue defects, who admitted to Department of Traumatic Orthopaedics, Guangzhou First People’s Hospital, Guangzhou Medical College from January 2007 to December 2008. They were all treated with vacuum sealing drainage technique to repair the wounds using high polymer foam materials. the negative pressure maintained at 20-60 kPa, and one time of vacuum sealing drainage could effectively drain 7-14 days. The dead space closure time, the time of eliminating wound infection, fresh granulation growth and complications were analyzed.
RESULTS AND CONCLUSION: Totally 32 cases were involved in the follow-up. Following average two weeks of vacuum sealing drainage treatment, dead space was closed in 22 cases and basically survived after skin grafting. Six patients accompanied with deep dead space, which was completely closed after the implementation of secondary vacuum sealing drainage. Four cases of large-area skin and soft tissue defects with exposed bone and infection underwent multiple debridement, the wounds were repaired using peripheral muscle flap translocation; except one case was re-infected with skin graft edge effusion, no one case appeared osteomyelitis with good wound healing; no other complications occurred, and postoperative wound healing rate was 96.8%, there was no incompatibility between human body and the materials.