Clinical Study Of MEBO Gauze Combined With VSD In The Treatment Of Skin And Soft Tissue Defect Of Hand Trauma

Objective:To study the clinical and long-term effects of MEBO gauze combined with vacuum sealing drainage（VSD）in the treatment of skin and soft tissue defect of hand trauma.Methods:Data of inpatients with skin and soft tissue defects of hands were collected from The Department of Burn and Plastic Hand Surgery,Affiliated Hospital of Yan’an University from June 2020 to June 2021.According to inclusion and exclusion criteria,40 cases were selected.There were 20 cases in experimental group and 20 cases in control group.The experimental group was treated with MEBO gauze and VSD after debridement,while the control group was treated with MEBO gauze after debridement.Later,according to the wound condition,direct suture or skin grafting was used to close the unhealed wound.The experimental group was fixed with VSD device,while the control group was fixed with traditional pocketing.The follow-up time was 6months after wound healing.Clinical results were mainly collected on the wound healing of patients 1 week after surgery（Granulation tissue formation rate,exudate condition and edema range of surrounding tissue）,the time between the first debridement and the second operation,skin graft survival rate and wound healing time,positive rate of bacterial culture on wound surface one week after operation.Long-term efficacy Data of functional sensation and appearance of patients 6 months after wound healing were collected for statistical analysis,and conclusions were drawn.Results:1.Comparison of general conditions between MEBO gauze combined VSD group and MEBO gauze treatment group:experimental group:15 males,5 females;Control group:16 males and 4 females.The average age of the experimental group was（50.30±8.25）years old.The average age of the control group was（47.40±7.97）years old.The average initial wound area of the experimental group was（9.26±4.38）㎝~2.The average initial wound area in the control group was（10.31±5.31）㎝~2.There were no statistically significant differences in gender,age and initial wound area between the two groups（P>0.05）.2.The granulation tissue formation rate was（62.16±8.40）%in the experimental group and（40.89±10.36）%in the control group.The degree of wound exudation in the experimental group was（2.90±0.79）layer,and that in the control group was（5.65±1.50）layer.The degree of tissue edema around the wound was（5.20±1.94）mm in the experimental group and（12.55±3.89）mm in the control group.The skin graft survival rate in the experimental group was（95.10±5.42）%,and in the control group was（90.11±6.47）%.The time between the first debridement and the second operation was（8.10±2.10）days in the experimental group and（14.65±3.33）days in the control group.The healing time of the experimental group was（23.85±2.54）days,and that of the control group was（33.45±3.55）days.There were statistically significant differences among all groups（P<0.05）.3.The positive rate of bacterial culture was 5.00%in the experimental group and 20.00%in the control group,the difference was not statistically significant（P>0.05）.4.The excellent and good rate of hand function was 85.00%in the experimental group and 60.00%in the control group.The total recovery rate of hand sensation was 60.00%in the experimental group and 35.00%in the control group.The excellent and good rate of hand appearance was 85.00%in the experimental group and60.00%in the control group,and there was no statistical significance（P>0.05）.Conclusion:In this study,MEBO gauze combined with VSD was proved to be effective in the treatment of skin and soft tissue defects caused by hand trauma.One week after operation,the wound healing effect was more significant than that of MEBO gauze alone.It can improve the survival rate of the second skin graft after debridement,shorten the wound healing period,reduce the occurrence of infection,and play a positive role in the clinical treatment effect.In the long term follow-up,the function,sensation and appearance of the postoperative hand were improved.The operation method is simple and fast,which is worthy of promotion by clinical researchers.However,more rigorous and rich experimental data are needed in the evaluation of long-term efficacy.