Vacuum sealing drainage combined with free anterolateral femoral skin flap grafting in 16 cases of pediatric soft tissue damage to the foot and ankle

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND

Gustilo III fractures have a high incidence and are difficult to treat. Patients often experience difficulty in wound healing. Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.

AIM

To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.

METHODS

Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People's Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects. They were divided into a study group (n = 40, healed with negative pressure closed drainage) and a control group (n = 40, healed with conventional dressing changes) according to the variation in the healing they received. The efficacy of the clinical interventions, the variations in the regression indicators (time to wound healing, time to fracture healing, time to hospitalization), and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.

RESULTS

The total effective rate of patients among the study group was 95.00% (38/40), which was notably higher than 75.00% (30/40) among the control group (P < 0.05). The wound healing time, fracture healing time, and hospital stay of the patients in the study group was shorter than the control group (P < 0.05). After the intervention, the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group (P < 0.05).

CONCLUSION

Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury. It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

Use of autologous iliac crest graft and free anterolateral femoral skin flap in diabetic foot ulcers: a case report

BACKGROUND

Diabetic foot has a great impact on the life of patients. Its treatment involves a multi-disciplinary and multi-direction approach, which requires not only soft tissue repair, but also bone reconstruction and functional repair.

CASE PRESENTATION

A 51-year-old Chinese man with a three-year history of diabetes was diagnosed with ulcers in his left foot. We performed a successful procedure, and the different strategies we adopted helped to avoid serious complications during treatment. The patient was treated with debridement, bone cement, iliac crest graft, and anterolateral femoral skin flap, and recovered well.

CONCLUSION

There is a dearth of reports pertaining to treatment of diabetic foot in patients with midfoot bone and soft tissue loss. In this report, we present an effective method that we used to reconstruct the loss of midfoot in a patient with diabetic foot, illustrating a successful therapeutic strategy for saving limbs in this complex medical condition.

Efficacy of prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review meta-analysis

INTRODUCTION

The susceptibility to surgical site occurrence (SSO) is high following ventral hernia repair (VHR) surgery. SSO severely increases the physical and mental burden on patients. The main purpose of this review was to analyze the efficacy of negative pressure wound therapy (NPWT) after open VHR(OVHR) and explore benefits to patients.

METHODS

The Cochrane Library, PubMed, and Embase databases were searched from the date of establishment to 15 October 2022. All randomized controlled trials and retrospective cohort studies comparing NPWT with standard dressings after OVHR were included. The Revman 5.4 software recommended by Cochrane and the STATA16 software were used in this meta-analysis.

RESULTS

Fifteen studies (involving 1666 patients) were identified and included in the meta-analysis, with 821 patients receiving NPWT. Overall, the incidence rate of SSO in the NPWT group was lower compared to the control group (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.21-0.93; I2 = 86%; P = 0.03). The occurrence rate of surgical site infection (SSI; OR = 0.51; 95% CI = 0.38-0.68, P < 0.001), wound dehiscence (OR = 0.64; 95% CI = 0. 43-0.96; P = 0.03), and hernia recurrence (OR = 0.51; 95% CI = 0.28-0.91, P = 0.02) was also lowered. There was no significant difference in seroma (OR = 0.76; 95% CI = 0.54-1.06; P = 0.11), hematoma (OR = 0.53; 95% CI = 0.25-1.11; P = 0.09), or skin necrosis (OR = 0.83; 95% CI = 0.47-1.46; P = 0.52).

CONCLUSION

NPWT can effectively decrease the occurrence of SSO, SSI wound dehiscence and hernia recurrence and should be considered following OVHR.

Roles of negative pressure wound therapy for scar revision

The purpose of this study is to review the research progress of negative pressure wound therapy (NPWT) for scar revision and discuss the prospects of its further study and application. The domestic and foreign literatures on NPWT for scar revision were reviewed. The mechanism and application were summarized. NPWT improves microcirculation and lymphatic flow and stimulates the growth of granulation tissues in addition to draining secretions and necrotic tissue. As a significant clinical therapy in scar revision, NPWT reduces tension, fixes graft, and improves wound bed. In the field of scar revision, NPWT has been increasingly used as an innovative and constantly improving technology.

Vacuum sealing drainage to treat Fournier's gangrene

BACKGROUND

Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier's gangrene (FG).

METHODS

Data of patients surgically treated for FG were retrospectively analyzed.

RESULTS

Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28-74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ² = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively.

CONCLUSION

VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.

Successful treatment of an infected wound involving calciphylaxis via vacuum sealing drainage: A case report

INTRODUCTION AND IMPORTANCE

The treatment of a complex calciphylaxis wound with infection continues to be a significant challenge in a clinical situation.

CASE PRESENTATION

We describe a case of an 87-year-old man presented with a nontraumatic painful ulcer on his right heel. Calciphylaxis was diagnosed by the biopsy. Although a serial therapy of sodium thiosulphate, tramadol hydrochloride, frequent dressing changes, and conventional surgical debridement initiated, the worsening skin wound covered with a necrotic base and blackish eschar was formed. Skin cultures returned positive for the growth of proteus mirabilis. Subsequently, the usage of vacuum sealing drainage appeared to be effective. A complete resolution occurred 12 weeks after vacuum sealing drainage therapy.

CLINICAL DISCUSSION

The infected wound due to calciphylaxis is not uncommon. Vacuum sealing drainage technique demonstrated the effective approach to deal with wound infections, especially in the early stage. As the initial measures of wound care, serial debridement and sodium thiosulphate treatment have not slowed down the progress of the disease in this case, the vacuum sealing drainage along with the creative use of topical antibiotic flushing provided the best solution to promote healing of the infected field.

CONCLUSION

This case highlights that vacuum sealing drainage technique could be considered in patients presenting with an infected wound involving calciphylaxis.

Effect of vacuum sealing drainage plus skin grafting on deep burns and analysis of risk factors for postoperative infection

OBJECTIVE

To analyze the effect of vacuum sealing drainage (VSD) plus skin grafting on deep burns and the risk factors of postoperative infection.

METHODS

A retrospective analysis was conducted on 124 patients with deep burns who were admitted to the Taizhou People's Hospital from February 2019 to February 2021. The 55 patients who underwent traditional dressing change therapy plus second-stage skin grafting became the control group. The remaining 69 patients treated with first stage VSD plus second-stage skin grafting became the observation group. Wound healing time, hospital stay, postoperative infection, wound closure success rate, pain degree, and scar hyperplasia were recorded and compared between the two groups. Logistic regression was used to analyze the risk factors of postoperative infection in patients.

RESULTS

Compared with the control group, the observation group had a shorter time of wound healing and hospital stay, lower postoperative wound infection rate and lung infection rate, higher success rate of wound closure, lower pain degree scores on the 7th day after the operation, and less scar hyperplasia (all P<0.05). Logistic regression analysis revealed that burn degree, treatment plan, proportion of burn area, and wound healing time were the factors affecting postoperative infection in patients.

CONCLUSION

VSD plus skin grafting have significant effects on deep burns. This combined treatment reduced the occurrence of the wound infection, relieved pain, shortened the healing time and hospitalization time, and reduced the proliferation of scars in the later stage.

Analysis of DAT Combined with the VSD Technique in Wound Repair of Rats and Its Effect on Inflammatory Factors

The clinical efficacy of decellularized adipose tissue (DAT) combined with vacuum sealing drainage (VSD) in the treatment of wound healing in rats is investigated, and the changes of inflammatory factors are analyzed. The tissue defect model of SD (Sprague-Dawley) rats is established and divided into the combined group (n = 12) and the control group (n = 12) according to different treatment methods. The control group is treated with a single VSD technique, and the combined group is treated with DAT on the basis of the control group. The wound healing time of the two groups is observed. Wound tissue is collected 1 day, 10 days, 20 days, and 30 days after treatment, and neutrophil infiltration is observed by HE (hematoxylin-eosin) staining. The expression changes of IL-6 and IL-13 at each time point before and after treatment are compared. Histological observation shows that the cell infiltration is reduced in both groups, and the wound repair in the combined group is better than that in the control group. The experimental results show that the DAT combined with the VSD technique can further speed up wound healing and reduce inflammation in rats.

Intervention Effect of Evidence-Based Nursing on Postoperative Recovery of Vacuum Sealing Drainage in Patients with High Perianal Abscess with Magnetic Resonance Imaging Sequence Images

The purpose of this study was to evaluate the intervention effect of evidence-based nursing (EBN) on vacuum sealing drainage (VSD) recovery of patients with high perianal abscess after vacuum sealing drainage based on magnetic resonance imaging (MRI) sequence images. 60 patients with high perianal abscess were selected, and 30 patients before VSD were selected as the control group. Routine nursing was implemented in the control group, 30 patients after VSD were observed, and EBN was implemented in the observation group. The detection rates of various types of perianal abscess with different sequence combinations were studied, and the effects of EBN on pain and anal function scores of perianal abscess patients were analyzed. Anal function and defecation were assessed, and postoperative complications were calculated. Different combinations of MRI sequences can reach higher detection rates of intersphincter abscess and ischial anal abscess. The observation group had better pain relief and anal function recovery. The complication rate of the observation group was 16.67%, which was significantly lower than that of the control group (P < 0.05). It was confirmed that different MRI sequence combinations had higher detection rates for intersphincter abscess and ischial fossa abscess. EBN can promote the recovery of anal function and reduce complications in patients with perianal abscess.