Comparative Study On The Promotion Of The Growth Of Granulation Tissue On The Wound Surface Among Children Between Vacuum Sealing Drainage And Routine Dressing Change

Purpose：To investigate the effect of vacuum sealing drainage (VSD) on angiogenesis ofnew granulation tissue on child acute wound, vascular endothelial growth factor(VEGF) expression and macrophage migration.Methods：40children with skin soft tissue avulsion of extremities and soft tissue defectresulting from injuries were selected, all of whose wound size were above5cm x5cm. They were hospitalized within6-8hours and treated with emergency debridement.After thorough debridement in stage I, the patients were divided into2groups with20children in each group. The experimental group were treated by VSD, while thecontrol group received common dressing therapy. New granulation tissues were takenon the7th and14th d respectively right after surgery and stained with S-Pimmunohistochemistry method. Micro vessel density (MVD), expression of VEGFand the change of macrophages number were observed.Results：1. The MVD values marked by CD34on the7th and14th d of experimentalgroup after VSD treatment were higher than those of control group, and there was asignificant difference (P <0.01); MVD value on the14th d after operation was higherthan that on the7th d in both experimental and control groups, and there wassignificant difference in each group (P <0.05).2. VEGF expression in vascular endothelial cells of granulation tissue inexperimental group after VSD treatment was significantly increased compared tocontrol group, VEGF label indexes on the7th and14th d were higher than those ofcontrol group, and there was a significant difference (P <0.01); The VEGF labelindex on the14th d after operation was higher than that on the7th d in bothexperimental and control groups, and there was significant difference in each group(P <0.01). 3. Numbers of macrophages were obviously increased on the7th in experimentalgroup after VSD treatment, and markedly higher than those on the7th in controlgroup, the difference was statistically significant (P <0.01); But on the14th d therewas no statistical differences(P＞0.05);The number of macrophages on the7th d and14th d in experimental groups showed no statistical differences(P＞0.05). Thenumber of macrophages on the14th d after operation was higher than that on the7thd in control groups, and there was significant difference in this group (P <0.01).Conclusions:1. Compared to conventional treatment, the VSD treatment can promote thevascularization of wound obviously, enhance the expression of VEGF, and shorten thetime of wound healing.2. VSD can enhance the migration and activation of macrophages of wound,induce tissue cell proliferation, and make the granulation tissue in raw surface growbetter and faster3. Compared to conventional treatment, the VSD technique has positive curativeeffect on large area injury wound of child skin soft tissue.