Treatment of large area skin avulsion injury with a combination of bridge flaps and skin graft covered by vacuum sealing drainage

Abstract

Objective To explore the surgical technique and clinical effectiveness of treatment for posttraumatic large area skin avulsion injury with a combination of bridge flaps and skin graft covered by vacuum sealing drainage (VSD). Methods Sixteen cases with posttraumatic large area skin avulsion injury were treated by free skin graft covered by VSD. There were 7 males and 9 females, with an average age of 23.5 years (range from 7 to 58 years). The size of wound varied from 6% to 22%, 3 cases combined with bone fracture and deep tissue exposed. After the wound were completely debrided, the skin graft were performed with posttraumatic large area skin soft tissue defect. Then VSD was used to covered the wound with a period of 7 to 10 d according to the wound condition. Survival rate and quality healing of the flaps were followed up postoperatively. Results The granulation growth of 15 cases with large area soft tissue defect was good after the complete debridement and the application of VSD. The survival rate was 90%-100%, with the average of 95.8%. All the flaps were successful with good infection control and no sinus. The wound was infected in one case. A total of 12 cases were followed-up. The average period of follow-up was 6-18 months. All the patients were satisfied with the good outline and good function of the affected limb. Conclusion Patients with posttraumatic large area skin soft tissue defect can be effectively treated with the free skin graft covered by VSD, which can shorten the course of treatment, and restore the function of affected extremities as much as possible. Key words: Surgical flaps; Skin transplantation; Vacuum sealing drainage