Thérapie séquentielle associant pansement aspiratif, greffe dermique artificielle puis greffe fine cutanée pour de larges pertes de substances cutanées infectées chez l’enfant

Abstract

ObjectiveTo evaluate the efficacy of a “vacuum sealing drainage (VSD) – artificial dermis implantation (ADI) – thin partial thickness skin grafting (TSG)” sequential therapy for deep and infected wounds in children. Materials and methodsFifty-three pediatric patients with deep and infected wounds were treated with sequential VSD-ADI-TSG therapy. The efficacy of this treatment was compared with that of the surgical debridement-change dressings-thin partial thickness skin grafting previously performed on 20 patients. Survival of tissue grafts, color and flexibility, subcutaneous fullness and scar formation of the graft site were examined and compared. ResultsThe sequential therapy combined the advantages of the VSD treatment, in reducing tissue necrosis and infection on the wound surfaces and promoting the growth of granulation tissue, with the enhancement of grafting by artificial dermis. Compared with the 20 controls, skin grafted on the artificial dermis was more smooth and glossy, while the textures of the region were more elastic, and the scars were significantly lighter in Vancouver scale. ConclusionThe sequential VSD-ADI-TSG therapy is a simple and effective treatment for children with deep and infected wounds. Level of evidenceIV.