The Clinical Application Of The Vacuum Sealing Drainage(VSD) Technology In The Dermatoplasty Of Large Area Of Cutaneous Defects.

ObjectiveThe skin grafting of large area skin wounds and complex wounds is a frequently encountered clinical problem. The traditional packaged skin grafting is complicated and time-consuming, not conducive to observe postoperative efficacy, and has the possibility of skin necrosis or infection. Vacuum sealing drainage technology (vacuumsealingdrainageVSD) is a new treatment method which had been successfully applied to a wide range of clinical work in recent years. This paper aims to study the clinical application of VSD in large area skin wounds and complex wounds.Target and Methods1. Choosing target for study(1)Test groupWe selected 45 cases of large skin defect patients as the test group from 2008.03 to 2010.03 in our hospital; males:27, female:18; aged from 7 years to 45 years, an average of 25 years old; 9 cases in upper limb,2 cases in hip and lower back,33 cases in lower limb,1 case in perineum. All the cases have no medical basis for diabetes and other diseases, and the area of skin defect is above 8 cm×12cm.All the the granulation tissue is fresh and has no purulent exudate through treatment with VSD or changing dressings.(2)Control groupWe selected 42 cases of large skin defect patients at the same time in our hospital as the control group. Male:25 cases; female:17 cases; aged from 3 to 57 years, average 27 years; 10 cases in upper limb,1 case in waist and hip,31 cases in lower limb. All the cases have no medical basis for diabetes and other diseases, and all the area of skin defects is above 8cm×12cm. All the granulation tissue is fresh and has no purulent exudate through treatment with VSD or changing dressings.2. MethodsAll the cases with effective treatment received superficial thickness dermatoplasty when the granulation tissue is fresh.The experimental group were covered with VSD and semi-permeable membrane. The VSD was removed about seven days later. The control group were covered with the traditional dermatoplastic package and were removed about ten days later. Evaluated the clinal effect by reference to clinical outcome.Results1. Comparison of survival rate of skin after transplanted with the two methodsThe test group were treated with pressurized skin grafting covered with VSD. The skin graft of the total 40 cases were survived, only five cases had marginal necrosis. The survival rate of 88.89% in control group.The control group were treated with traditional packaging and skin grafting. The result in the control group:28 cases was survived; 11 cases were marginal skin graft necrosis; 3 cases were large necrosis and 2 cases with twice surgery, the survival rate is 66.67%.The two methods had significant difference by statistical analysis. The survival rate of skin graft in the test group is higher than the control group.2. Comparison of wound infection in the two group:Only 1 case in the test group was surface infection and cure by dressing,the rate of infection being 2.22%.8 cases in the control group were wound infection, the rate of infection being 19.05%. The two methods had significant difference by statistical analysis.The infection rate is lower in the test group than in the control group.ConclusionThe clinical application of VSD technology in the dermatoplasty of large area of skin wounds and complex wounds is benefit to the skin flap survival, reduce the marginal necrosis, prevent infection. It can ensure the success rate of surgery,shorter hospitalization time,reduce the suffering of patients.