Treatment of severe large area of skin avulsion injury complicated with infected and necrotic wound

Objective To summarize the treatment methods of severe large area of skin avulsion injury complicated with infected and necrotic wound.Methods Twenty-one cases of severe large area of skin avulsion injury complicated with infected and necrotic wound were admitted to People's Hospital of Jiangmen from January 1996 to June 2011.Necrotic tissues were debrided and discharge was drained.Wound with granulation and less infection and necrosis were auto-grafted.Negative pressure drainage was applied to deep wound and wound with severe infection and necrosis.Wound with tendons and bones exposure were grafted with skin flaps,myocutaneous flaps or free skin flaps.Results Forty-six wounds within 21 cases healed well after surgery by stages.Nine negative pressure drainage was applied.There were 55 skin auto-grafting,26 local flaps transplantation,13 tensor fasciae latae myocutaneous transplant and 6 groin skin flaps transplantaion.All grafts survived except 5 partial distal flaps necrosed.Wound healing time was 31 to 102 days with average 48.10±12.14 days.Conclusions Severe large area of skin avulsion injury should be treated promptly.Debridement and drainage are crucial to prevent worsening of wound.Infected and necrotic wound could be healed shortly with correct methods of treatment.The function and appearance could be improved effectively.