Clinical study of vacuum sealing drainage combined with Lando® artificial dermis combined with autologous skin grafting for the treatment of wounds with bone and tendon exposure and bone fracture of hand and foot

Objective To investigate the clinical effect of vacuum sealing drainage combined with artificial dermis combined with autologous skin grafting for the treatment of wounds with bone and tendon exposure and bone fracture of hand and foot. Methods Thirty-five patients (including 23 cases of hand and 12 cases of foot) with bone and tendon exposure and bone fracture of hand and foot were treated in the Department of Trauma Microsurgery, Zhengzhou Renji Hospital from November 2017 to February 2019. The fracture was fixed at the first stage, wound debridement and hemostasis following. Wound bed was prepared with vacuum sealing drainage device, and after that, Lando® artificial dermis was applied. After complete vascularization, the silicone membrane was removed and the autologous skin was applied. Follow-up was performed for 6 to 12 months, and skin graft survival situation and long-term recovery appearance were performed. Results Thirty-five patients removed the negative pressure device 10 to 15 days after the artificial dermal covering, the stent vascularized well and completely covered the exposed bone and tendon. After autogenous skin graft transplantation, except for one case, which caused partial necrosis of the skin graft due to failure to drain in time, the skin graft wound was healed again after dressing change, and in the rest of the patients the transplanted autologous skin graft basically survived. The transplanted autologous skin survived completely. The follow-up results of 6 to 12 months after operation showed that the wound was not broken, and the skin color was close to that of the surrounding normal skin. There was no obvious scar hyperplasia and tendon adhesion, and the functional recovery was satisfactory. Conclusions Vacuum sealing drainage combined with Lando® artificial dermis combined with autologous skin graft repair of exposed bones and tendons of the hands and feet, which can directly cover exposed bones and tendons. The appearance of the transplanted areaand the function is well, which is worth popularizing. Key words: Skin, artificial; Skin transplantation; Fracture, bone; Bone exposure; Tendon exposure