The use of a skin-stretching device combined with vacuum sealing drainage for closure of a large skin defect: a case report

Lian-Yang Zhang,Lei Liu,Zhao-Wen Zong,Si-Heng Du,Qing-Shan Guo,Ying Lei

doi:10.1186/s13256-018-1779-8

Lian-Yang Zhang, Lei Liu + Show 4 more

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https://doi.org/10.1186/s13256-018-1779-8

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Abstract

BackgroundThis case report presents the treatment of a large infected skin defect, which was caused by an accidental explosion, through a skin-stretching device combined with vacuum sealing drainage. To the best of our knowledge, the area of the wound that we treated may currently be the largest.Case presentationA 41-year-old Asian man was transferred to the Center of Trauma Surgery of our hospital for the closure of an open infected wound with a large skin defect in his right lower limb caused by an accidental explosion of 100 pieces of blasting cap. The wounds located in his right gluteal were approximately 40 cm × 35 cm. On admission, the wounds had hemorrhaged, exhibiting a darkened appearance, and included scattered metallic foreign bodies. Debridement of his right gluteal area was conducted 6 hours after injury. Subsequently, a skin-stretching device combined with vacuum sealing drainage was applied to reduce the skin defect. This treatment proved to be valuable for the closure of the skin defect and to attain successful functional rehabilitation without sciatic nerve entrapment or amputation in this case.ConclusionsIt is difficult to close large skin defects, especially when they are infected. The application of a skin-stretching device combined with vacuum sealing drainage should be commonly applied to treat infected wounds because it is a safe and easy operative technique.

Highlights

This case report presents the treatment of a large infected skin defect, which was caused by an accidental explosion, through a skin-stretching device combined with vacuum sealing drainage
The application of a skinstretching device combined with vacuum sealing drainage should be commonly applied to treat infected wounds because it is a safe and easy operative technique
There have been no reports of significantly large wounds that have been directly sutured without additional techniques using gradually reduced attraction material to facilitate skin stretching

Summary

Conclusions

The application of a SSD combined with VSD should be commonly applied to treat wounds that are complicated with infection, as it is a safe and reproducible technique, and we believe this technique can be incorporated into the clinical practice of any (plastic) surgeons performing large scar excisions or routinely facing the problem of closing large defects [8, 9]. The use of an external skin-stretching device for wound management in a rabbit. 6. Baird R, Gholoum S, Laberge J-M, et al Management of a giant omphalocele with an external skin closure system. 8. Verhaegen PD, van der Wal MB, Bloemen MC, et al Sustainable effect of skin stretching for burn scar excision: long-term results of a multicenter randomized controlled trial. Traction-assisted dermatogenesis by serial intermittent skin tape application. L-YZ, YL, and Z-WZ participated in the study design and coordination and helped draft the manuscript. All authors read and approved the final manuscript. Ethics approval and consent to participate Not applicable. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations

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