Vacuum sealing drainage plus flap in the treatment of leg open fracture with severe soft tissue defect

Objective To explore the efficacy of using vacuum sealing drainage(VSD) for the treatment of open fracture with severe soft tissue defect.Methods 58 patients with lower limb open fracture and severe soft tissue defect were divided into two groups.Control group(27 cases) was treated by debridement,and delayed skin transplantation or local flap graft,and internal fixation.VSD group(31 cases) was treated by debridement,internal fixation,and the wound surface being covered with VSD at the same time.The wounds were closed with secondary suturing,or skin transplantation,or local flap graft 7 to 21 d after debridement.Results Time of bone union were:6~18(9.8±2.91) months in the control group,and 4~10(6.29±1.88)months in the VSD group(P0.05).Time of wound surface healing were: 20~95(46.81±16.80)d in the control group,and 14~33(19.68±5.30)d in the VSD group(P0.01).There was no significant difference in the time of bone union between Gustilo ⅢA and Gustilo ⅢB(P0.05).But the wounds healing time of Gustilo ⅢA was significantly shorter than ⅢB in the two groups respectively(P0.01,P0.05).Conclusions VSD can shorten the wounds healing time of open fracture with severe soft tissue defect.