Application: Complex Wounds Of Feet And Legs Management With Vacuum Sealing Drainage

Objective：With the development of industry, building industry andtransportation industry, various accidents, corresponding troubles and disastersimmediately increase, leading to the increaseing amount of orthopedicspatients. Trauma induced an increase of injuried and disabled persons. Inaddition, the life span is latent to lose, and the economy bears huge. Clinically,it was challenging to manage various soft-tissue defects of the local skincomplicated by bone, joint, tendon, vessels and nerves exposed. Suchdifficult-to-heal wounds usually are heavily contaminated and easily infected.The traditional saline·-wet·-to·-dry dressings are not satisfactory, becauseof encountered hard and friction. They are used to treat the skin and softrefractory wound to gain a torpid proliferation of the granulation tissue fordecades of years. The wounds take a long time to heal, because of bad localblood flow, wound edema and infection. It can even result in worsening softtissue injury and may make important tissue and plate uncovered, tendonnecrosis,osteomyelitis, bone nonunion and failure of internal fixation as wellas external fixation．Patients are suffering from dressing change which mayfrequently happens．The doctors have to spend a lot of time in changing thedressings，which makes an adverse effect on their work．An advanced therapywas needed urgently for both doctors and patients．At the beginning of1990s, vacuum sealing drainage was invented byDoctor Fleischmann from Germany University of Ulm, which had asignificant effect on the treatment of soft tissue wounds. The VAC was firstinvestigated by Morykwas and Argenta in1997.They watched many animalexperiments and300cases of clinical trials of acute and chronic wounds, andprovided the experimental and clinical basis for the technology. In1994,Professor Qiu Huade took the lead in the domestic introduction of the technology, leading to the first application of this technology in generalsurgery in the world. At present it has been widely used in many patients and avariety of wounds in general surgery, burn unit, plastic surgery, orthopedics,cardiothoracic surgery, urology and other disciplines.Methods: From August2011to November2011，a total of18patientswith complex wounds of feet and legs，which were treated by VSD in ourdepartment. We watched and recorded each patient ’s wound before and afterthe treatment，the frequency of VSD used，the time they spent，and theirsatisfaction to the very treatment．The wound secretion was also collected forgermiculture before and after the treatment.All above was to explore thefeasibility, experience, lessons,indications, contraindications, and effects ofVSD.Results:1.The average times of VSD used is1.5times, while the averagetimes hospitalization days are43.72days．2. All the wounds finally achievedfresh granulation tissue within2times of VSD. It is an effective treatment inmanaging the complicated wounds of feet and legs．3.All the wounds treatedwith VSD finally achieved healing after2months．4.All the patients have notoccurred complications．Conclusions: It is effective to apply VSD to repair skin and soft tissuecomplicated wounds of feet and legs, which can avoid cross-contamination,cut down infection rate, improve blood supply, shorten the hospitalizationdays, facilitate healing, and make patients more comfortable. In brief,VSDtherapy is a convenient and effective treatment in treating the skin and softtissue difficult-to-heal wounds．...