Clinical Research To VSD Reconstruct The Wounds Of Infective Bone Disease And Trauma Infection

Objective:according to introduce the method, the mechanism, the theory base and something need to pay attention of clinical study, problems and using of VSD, to show the evidence of treatment of the disease. Methods:There are 36 infection patients be treated with VSD. The age ranges from 13-54 years, averaging out at 43 years. Among the patients,24 cases were male, and 12 cases were female.All fractures have previously undergone fixation and vessel repair, with remaining trauma surface or skin necrosis area ranging 5cm×4cm×1cm～20cm×19cm×8cm. All cases were given debridement, and changed the pattern of fracture fixation or adjusting the position of outer fixation device. Then the VSD was applied in a region-and layer-wise manner in the inter muscular space, inter joint space and the inter fracture space, The sequential and time of tube withdrawal was decided by tube position and drainage pattern. With drainage changes every 5-7 days according to the drainage state. The drainage were applied 1-4 times per case, averaging out at 2.2 times. When fresh granulation tissue emerged in the trauma surface,5 cases undergone flap transplantation and muscle transplantation, and 31 cases (38 lesions) undergone skin graft or suture to cover the trauma surface. Results:The 35 cases investigated all showed well control of the trauma surface infection after debridement and subsequent vacuum drainage. The duration of clean trauma surface was 7-17 days, averaging out at 10.5 days. The swelling of the trauma surface was alleviated, fresh granulation tissue emerged, and the area of trauma surface were reduced by 10%-15%, with a negative result of bacterial culture. Thirty-three cases of skin graft and tissue flap transplantation showed one-time full recovery, and 2cases of skin graft still hads mall trauma surfaces after first transplantation, fully recovered by re-transplantation. All patients were normal in body temperature and blood routine test, without local fistula or pain. Infection were effectively controlled. There was significant difference between 2 groups in time of secondary closure, times of dressing and total cost of treatment (P< 0.01). Conclusion:The VSD is a revolution of surgical draining, it could totally wiping of the secreting and necrotic tissue of lacuna and wounds, expedite concrescence of wounds. The technique is easy to master, curative effect is better than conventionally treatment.