Treatment of soft tissue defect of extremity by using vacuum sealing drainage in children

Objective To evaluate the efficacy of vacuum sealing drainage(VSD) in treating soft tissue defect of extremity in children.Methods Eighteen paediatric patients with post-traumatic soft tissue defects with or without bone or cartilage exposure of extremities were treated with VSD following debridement,and were then treated with dermatoplasty or skin flap grafting after one or two therapy courses,who received VSD treatments after dermatoplasty.Twenty patients with soft tissue defects in control group received traditional dressing.Results Fresh granulation grew well after VSD treatments in 15 cases(5 with bone exposure,3 with cartilage exposure and 4 with tendon exposure).Wound closure was performed by dermatoplasty.Two patients with large-area cartilage exposure and one patient with large-area tendon exposure received skin flap grafting because of poor granulation growth after VSD treatment.All cases recovered.Compared with the control group,the time from injury toⅡ period operation and the hospitalization time were significantly shortened(P 0.01),and the dressing time was significantly reduced(P 0.01),and the healing of skin grafting was significantly elevated(P 0.05),but there was no statistical difference in the complication rate between the two groups(P 0.05).Conclusion The VSD procedure can accelerate granulation tissue growth,reduce operations of skin flap,allay patient's pain and shorten healing time.It's an effective method for treatment of soft tissue defect of extremity in children.But it should be adjusted according to the wound characteristics.Most of the cases with large-area cartilage exposure need skin flap operation besides VSD.