Clinical Application of Vacuum Sealing Drainage for the Treatment of Deep Burn Wounds

Background This study aimed to determine the effect of the clinical application of vacuum sealing drainage (VSD) on the treatment of deep burn wounds. Methods This single-blind, randomized, controlled study included patients who were admitted to our hospital with deep burns from January 2018 to December 2020; the patients were randomly divided into the VSD and control (CON) groups. The number of days from treatment to skin grafting; survival rate of the first skin graft; rate of positive bacterial culture; visual analog scale (VAS) pain score; and durations of wound healing, antibiotic drug use, and hospitalization were analyzed and compared between the groups. Results The application of VSD significantly shortened the number of days from treatment to skin grafting ( P < .05); improved the survival rate of the first skin graft in patients with severe burns ( P < .05); reduced the rate of positive bacterial culture ( P < .05); reduced the VAS pain score ( P < .05); and shortened the durations of wound healing ( P < .05), antibiotic drug use ( P < .05), and hospitalization ( P < .05). Conclusion Vacuum sealing drainage had a good clinical effect on the recovery of deep burn wounds.

Antibiotic-loaded bone cement combined with vacuum sealing drainage to treat deep sternal wound infection following cardiac surgery: the first case report

Background Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Here we first present a case of a patient successfully treated for antibiotic-loaded bone cement (ALBC) combined with vacuum sealing drainage (VSD) of DSWI. Case presentation This case report presented a patient who underwent open heart surgery, and suffered postoperatively from a DSWI associated with enterococcus cloacae. Focus debridement combined with ALBC filling and VSD was conducted in stage I. Appropriate antibiotics were started according to sensitivity to be continued for 2 weeks until the inflammatory markers decreased to normal. One month after the surgery, patient’s wound was almost healed and was discharged from hospital with a drainage tube. Two months after the stage I surgery procedure, the major step was removing the previous ALBC, and extensive debridement in stage II. The patient fully recovered without further surgical treatment. Conclusions The results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.

Analysis of the Clinical Effect of Vacuum Sealing Drainage on Patients with Limb Trauma

To analyze the clinical effect of vacuum sealing drainage (VSD) on patients with limb trauma. Methods: 136 patients with limb trauma received by our hospital from October 2018 to October 2019 were selected as the study objects. According to the random number method, they were divided into two groups, 68 cases in each group. The control group was treated with conventional dressing change. The study group was treated with VSD to observe the wound healing effect, wound area and complications before and after treatment for 7 days. Result: After 7 days of treatment, the area of wound in the study group was significantly smaller than that in the control group, and the effect of wound treatment in the study group was significantly higher than that in the control group (P < 0.05); the incidence of complications in the study group was significantly lower than that in the control group (P < 0.05). Conclusion: VSD can effectively repair the wounds of patients with limb trauma, significantly improve the clinical treatment effect, and effectively prevent the occurrence of treatment complications, which is worth promoting.

Closure of Complex Wounds by a Simple Skin Stretching System Associated With Vacuum Sealing Drainage—Clinical Outcome of 34 Patients

Management of complex wounds with large skin defects presents a real challenge for orthopedic or reconstructive surgeons. We developed a simple skin stretching system associated with vacuum sealing drainage to examine the efficiency and complication. A total of 34 patients with different types of complex wounds were retrospectively included from January 2015 to March 2021. All patients in the study were underwent the treatment by 2 stages. The method was used to the wounds from 4.71 to 169.65 cm2 with a median defect size of 25.13 cm2. The median time for wound closure was 11.5 days (range: 5-32 days), although the median absolute reduction was 2.08 cm2/day (range: 0.15-25.66 cm2/day). Depending on the site of the wounds, the cause of the wound, and the rate of max-width/max-length ( W/ L), these complex wounds could be separately divided into several groups. There were statistically significant differences in the median value of the above variables ( P < .05 Kruskal–Wallis test). The results showed that different anatomical sites had different viscoelastic properties, the complex wounds caused by trauma were easier to close than caused by diabetic foot and the complex wounds in group A ( W/ L ＞ 0.5) were more difficult to close than in group B ( W/ L ≤ 0.5). No major complications were encountered in this study. In summary, the results of our study showed that the simple skin stretching system associated with vacuum sealing drainage was a safe approach for closure of complex wounds. Nevertheless, more attention should be paid to the viscoelasticity of the wounds to ensure closure and avoid undue complications when applying the method.

Antibiotic-Loaded Bone Cement Combined With Vacuum Sealing Drainage To Treat Deep Sternal Wound Infection Following Cardiac Surgery: The First Case Report

Background: Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Here we first present a case of a patient successfully treated for antibiotic-loaded bone cement(ALBC) combined with vacuum sealing drainage(VSD) of DSWI.Case presentation: This case report presented a patient who underwent open heart surgery, and suffered postoperatively from a DSWI associated with enterococcus cloacae. Focus debridement combined with ALBC filling and VSD was conducted in stage I. Appropriate antibiotics were started according to sensitivity to be continued for two weeks until the inflammatory markers decreased to normal. One month after the surgery, patient’s wound was almost healed and was discharged from hospital with a drainage tube. Two months after the stage I surgery procedure, the major step was removing the previous ALBC, and extensive debridement in stage II. The patient fully recovered without further surgical treatment.Conclusions: The results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.

Tibial Cortex Transverse Distraction Combined With Debridement and Vacuum Sealing Drainage for Diabetic Foot Ulcers: Validation of Previous Published Study

Objective: Tibial cortex transverse distraction (TCTD) has been recently reported in treating diabetic foot ulcers. However, there is no further studies verifying the effectiveness. We performed TCTD combined with debridement and vacuum sealing drainage (VSD) for diabetic foot ulcers to test the effectiveness.Methods: This study includes 25 patients with diabetic foot ulcers from 3 hospitals. The ulcers of all the cases didn't heal for over 3 months. Then we performed TCTD combined with debridement and VSD for them. After the surgery, the patients were regularly followed-up for more than one year.Results: Among all the patients, one case underwent amputation because of aggravated infections. There were no cases with complication like tibia fractures. Pin-site infections occurred in 2 patients. The infected pin-site healed after changing dressings for 2 weeks. For the rest 22 patients, their ulcers healed at postoperative 8.2 ± 4.5 weeks. The postoperative visual analogue score (VAS) which indicated pain degree, reduced significantly when compared with preoperative VAS.Conclusions: When combined with other measures like debridement and VSD, TCTD can bring advantages for patients diagnosed with diabetic foot ulcers, and the trauma of this operation remains a factor to be considered.Type of study/level of evidence: Therapeutic IV.

Early wound repair versus later scar repair in children with treadmill hand friction burns

The incidence of pediatric treadmill hand friction burns has been increasing every year. The injuries are deeper than thermal hand burns, the optimal treatment remains unclear. This was a retrospective study of children who received surgery for treadmill hand friction burns from January 1, 2015, to December 31, 2019, in a single burn center. A total of 22 children were surveyed. The patients were naturally divided into two groups: the wound repair group (13 patients), which was admitted early to the hospital after injury and received debridement and vacuum sealing drainage initially, and a full-thickness skin graft later; and the scar repair group (9 patients), in which a scar contracture developed as a result of wound healing and received scar release and skin grafting later. The Modified Michigan Hand Questionnaire score in the wound repair group was 116.31 ± 10.55, and the corresponding score in the scar repair group was 117.56 ± 8.85 (P&gt;0.05), no statistically significant difference. The Vancouver Scar Scale score in the wound repair group was 4.15 ± 1.21, and the corresponding score in the scar repair group was 7.22 ± 1.09 (P&lt;0.05). Parents were satisfied with the postoperative appearance and function of the hand. None in the two groups required secondary surgery. If the burns are deep second degree, third degree, or infected, early debridement, vacuum sealing drainage initially, and a full-thickness skin graft can obviously relieve pediatric pain, shorten the course of the disease, and restore the function of the hand as soon as possible.