Clinical Application Of Skin Flap Combined With VSD Treatment In Large Area Of Tissue Defect Of Foot

ObjectiveTo observe the clincial effect of skin flap combined with VSD treatment in large area of tissue defect of foot.Materials and Methods76 cases with large area soft tissue defects of foot in our department from 2012 March to 2013 September were divided into two groups randomly,of which 40 patients in treatment group received VSD combined with flap operation,36 cases in the control group were received the wound dressing combined with flap operation treatment.Results1. The patients in experimental group and control group were removed by vacuum sealing drainage device after 7d,the experimental group of granulation tissue of the excellent rate was 75%(30/40), significantly better than the control group 25% (9/36), the difference was statistically significant (P<0.01). The experimental group wound situation improved obviously,15 patients received skin grafting way closure, 25 patients underwent flap operation therapy; the control group patients underwent flap operation treatment.flap operation,2. Before the skin flap surgery, preoperative complications of experimental group such as infection, increased body temperature and hypoalbuminemia,are significantly lower than those in the control group. The comparative differences have statistical significance (P< 0.05 or 0.01).3. Two groups of patients were given VSD, debridement dressing after 7d treatment, the CTGF expressed in the experimental group, control group, positive particles density values are respectively(0.126±0.035), (0.501±0.044),it has significant difference (t=10.113, P< 0.01).4. Before the skin flap surgery,the pain response of experimental group were obviously slight than control group, And the experimental group’s tiny trauma proportion were obviously higher than control group’s, the difference was statistically significant (P< 0.01).5. The skin flap of experimental group were all survived, the unique blood vessel crisis were remitted by thrombolysis and spasmolysis medicine.The skin flap of control group appeard two crisis which were remitted by thrombolysis medicine, and appeared six partial necrosis which were cured by changing fresh dressing.The function of our patients’ feet present efficient recovery in follow-up visit.ConclusionFor the treatment of large defect of foot organization, the VSD combine with flap method is more simple and effective. Compared with the wound dressing combine with flap method, the VSD combine with flap method obviously reduced the pain of the patients. VSD also have the advantages such as low infection rate, high success rate and good tolerance.It is really deserve to widely popularize the VSD combine with flap method in Clinical application.