Objective: To investigate the clinical effect of vacuum sealing drainage (VSD) on late-stage large skin avulsion injury with infection.
Methods: From May 2007 to August 2008, 9 patients with large-area skin avulsion injury and infection were treated. There were 1 male and 8 females aged 9-52 years old (median 27 years old). All patients suffered from closed skin avulsion injury involving the lower back, buttock, and part of the thigh. The injury area varied from 30 cm x 25 cm to 92 cm x 38 cm. The time between injury and hospital admission was 15-23 days. The skin avulsion injury was complicated with pelvis fracture, urethral injury, anal injury, sacrum exposure, and limb fractures. The interval between hospital admission and operation was 3-23 hours. Free split-thickness skin graft was performed after the focus debridement and three VSD treatments (40-60 kPa).
Results: After three VSD treatments, no patient had general pyemia and severe local tissue necrosis or infection, the tissue edema in the skin avulsion area was alleviated obviously, and all the wound cavities were closed. All the wounds in the graft site healed after 28-45 days of treatment (average 39 days), and all the donor sites healed. Nine patients were followed up for 4-14 months (average 10 months). The appearance of the reparative area was good, and there was no occurrence of joint dysfunction in the injured area due to scar contracture.
Conclusion: VSD is effective in treating late-stage large skin avulsion injury with infection.