Objective To observe the effectiveness of vacuum seal ing drainage (VSD) combined with anti-taken
skin graft on open amputation wound by comparing with direct anti-taken skin graft. Methods Between March 2005 and
June 2010, 60 cases of amputation wounds for limbs open fractures were selected by using the random single-blind method.
The amputation wounds were treated with VSD combined with anti-taken skin graft (test group, n=30) and direct anti-taken
skin graft (control group, n=30). No significant difference was found in age, gender, injury cause, amputation level, defect size,
preoperative albumin index, or injury time between 2 groups (P gt; 0.05). In test group, the redundant stump skin was used
to prepare reattached staggered-meshed middle-thickness skin flap by using a drum dermatome deal ing after amputation,
which was transplanted amputation wounds, and then the skin surface was covered with VSD for continuous negative pressure
drainage for 7-10 days. In control group, wounds were covered by anti-taken thickness skin flap directly after amputation, and
conventional dress changing was given. Results To observe the survival condition of the skin graft in test group, the VSD
device was removed at 8 days after operation. The skin graft survival rate, wound infection rate, reamputation rate, times of
dressing change, and the hospital ization days in test group were significantly better than those in control group [ 90.0% vs.
63.3%, 3.3% vs. 20.0%, 0 vs. 13.3%, (2.0 ± 0.5) times vs. (8.0 ± 1.5) times, and (12.0 ± 2.6) days vs. (18.0 ± 3.2) days, respectively]
(P lt; 0.05). The patients were followed up 1-3 years with an average of 2 years. At last follow-up, the scar area and grading, and twopoint
discrimination of wound in test group were better than those in control group, showing significant differences (P lt; 0.05).
No obvious swelling occurred at the residual limbs in 2 groups. The limb pain incidence and the residual limb length were better
in test group than those in control group (P lt; 0.05). Whereas, no significant difference was found in the shape of the residual limbs between 2 groups (P gt; 0.05). In comparison with the contralateral limbs, the muscle had disuse atrophy and decreased
strength in residual limbs of 2 groups. There was significant difference in the muscle strength between normal and affected limbs
(P lt; 0.05), but no significant difference was found in affected limbs between 2 groups (P gt; 0.05). Conclusion Compared
with direct anti-taken skin graft on amputation wound, the wound could be closed primarily by using the VSD combined with
anti-taken skin graft. At the same time it could achieve better wound drainage, reduce infection rate, promote good adhesion of
wound, improve skin survival rate, and are beneficial to lower the amputation level, so it is an ideal way to deal with amputation
wound in the phase I.
Citation： LIAO Qiande,XU Jian,WENG Xiaojun,ZHONG Da,LIU Zhiqin,WANG Chenggong.. EFFECTIVENESS OF VACUUM SEALING DRAINAGE COMBINED WITH ANTI-TAKEN SKIN GRAFT FORPRIMARY CLOSING OF OPEN AMPUTATION WOUND. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(5): 558-562. doi: Copy