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Severe open injury of lower limbs is complex and difficult to cure in a short time,which can lead to serious infection,amputation and so on.For the treatment of open injury,wound repair is extremely important.A variety of new technologies such as new dressings,platelet-rich plasma(PRP),and vacuum sealing drainage(VSD)have recently been applied to lower limb wound repair,which can not only improve the functional prognosis and aesthetic effect,but also improve the quality of wound healing.This review will summarize the research progress of wound repair methods for open injury of lower limbs,so as to further guide clinical application.
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Objective:To summarize the experience of vacuum sealing drainage(VSD) in treating emphysematous pyelonephritis.Methods:The clinical data of 5 patients with emphysematous pyelonephritis treated with VSD from January 2013 to October 2022 in Zhengzhou Central Hospital Affiliated to Zhengzhou University were retrospectively analyzed. There were 1 male and 4 female patients.The average age was (61.4±6.6) years old. Clinical manifestations were chills and fever in 5 cases, lumbago in 5 cases. There were 3 cases of nausea and vomiting. Four cases were complicated with electrolyte disturbance. 4 cases suffered abnormal renal function. The levels of C-reactive protein, procalcitonin and interleukin-6 were higher than normal in 5 cases. Leukocytes and neutrophils was beyond normal in 3 cases, and lower than normal in 1 case. Five cases were complicated with diabetes, and 2 cases were complicated with ureteral calculus and obstruction. According to the CT results of emphysematous pyelonephritis reported in the literature, it can be divided into Ⅰ-Ⅳ types. Type Ⅰwas confined to the renal collecting system. Type Ⅱ was confined to the renal parenchyma. Type Ⅲ was confined to the renal parenchyma, and typeⅣ was bilateral emphysematous pyelonephritis or isolated renal emphysematous pyelonephritis. Of the 5 cases, 3 were type Ⅲ and 1 was type Ⅳ (bilateral). One case of type Ⅱ progressed to type Ⅲ. Under the controlling of blood glucose and applying broad-spectrum antibiotics, all 5 cases underwent ureteral stenting. Three patients underwent percutaneous renal puncture drainage, and VSD was performed after treatment failed. Among the two cases, one patient was type Ⅳ.And the other's CT showed that the kidney was heavy with gas and less normal renal parenchyma, and VSD was performed directly. The renal sac was opened surgically and the wound was sealed with a semi-permeable membrane. Foam sponge dressing was placed around the kidney for negative pressure irrigation for full decompression and drainage.Results:The leukocytes and neutrophils of 5 patients returned to normal after operation. The inflammatory indicators such as C-reactive protein, procalcitonin and interleukin-6 showed a downward trend to varying degrees compared with those before operation. The vital signs such as blood pressure, heart rate and temperature of the patients gradually became normal and stable. The VSD was replaced once every 1 to 3 days and was replaced 3 to 5 times. After 2 to 8 weeks of treatment, the blood leukocytes and kidney function of the patient returned to normal. All patients were followed up for 3 to 24 months with good prognosis and no recurrence of infection. No renal atrophy was observed during intermittent CT examination.Conclusions:When medical treatment combined with ureteral stent placement and percutaneous renal puncture drainage are not effective, or when stones are complicated with obstruction and puncture drainage is not effective, the use of VSD in the treatment of emphysematous pyelonephritis can reduce the difficulty of surgery and preserve the kidney. However, the number of cases in this study is small, and the conclusion needs to be further verified by increasing the sample size.
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Objective:To investigate the therapeutic effect of skull drilling and/or grinding combined with artificial dermis and vacuum sealing drainage in repairing scalp defects with skull exposure.Methods:From October 2014 to May 2018, 18 patients with scalp defect and skull exposure were treated in the Department of Burn and Plastic Surgery, the Second Clinical College of North Sichuan Medical College, including 10 males and 8 females, with an average age of 64 years (range, 34-86 years). The patients were divided into two groups: group A (by drilling skull or/and grinding combined with artificial dermis cover and vacuum sealing drainage plus two split thickness skin graft repair) and group B (by drilling skull or/andgrinding combined with artificial dermis cover plus two covering leather grinding stage split thickness skin graft repair), 9 cases in each group. The head wound granulation tissue, postoperative complications, skin graft survival rate and wound healing time were compared between the two groups. Vancouver scar assessment scale (VSS) was used to evaluate the wound healing in the two groups.Results:The time of granulation cultivation in group A and group B was (16.44±1.42) days and (29.11±13.32) days, the difference was statistically significant ( P<0.05); The wound healing time of group A and group B was (26.00±3.32) days and (40.67±14.37) days, the difference was statistically significant ( P<0.05); The postoperative complications of group A and group B were 1 case and 5 cases respectively, the difference was statistically significant ( P<0.05). The skin graft survival rates of group A and group B were (97.11±3.44)% and (95.00±4.74)%, the difference was not statistically significant ( P>0.05); The wound scar VSS scores of group A and group B were (7.67±1.32) points and (8.78±1.99) points, the difference was not statistically significant ( P>0.05). Conclusions:By drilling skull and/or grinding combined with artificial dermis cover and vacuum sealing drainage and two stage split thickness skin graft for repairing scalp defect with skull exposure wound can not only better scalp defect with skull exposure wounds, and reduce the postoperative complications, and significantly accelerate wound healing, but also can effectively improve the quality of wound healing, which is worthy of clinical application.
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BACKGROUND: Vacuum sealing drainage can enhance acute and chronic wound healing. The ratio of collagen type I/III play a critical role in the structural stability of skin tissue and skin repair, but its change during vacuum sealing drainage accelerating wound healing remains unclear. OBJECTIVE: To observe the effect of vacuum sealing drainage on the ratio of collagen type I/III during wound healing and to explore the potential mechanism underlying acute wound repair in rats. METHODS: A full-thickness wound, with a diameter of 20 mm, was created on the back of healthy male rats. All model rats were then randomized into two groups: blank control and vacuum sealing drainage groups. The wound surface was photographed at three observational time points (1, 3, 7 days after operation), and wound closure rate was calculated and compared. The mRNA and protein expression levels of type I collagen and type III collagen and ratio of collagen type I/III were detected by RT-qPCR and immunohistochemistry. The structure of granulation tissue and length of re-epithelialization were histologically detected. RESULTS AND CONCLUSION: Compared with the blank control group, treatment with vacuum sealing drainage significantly increased the expression of type I collagen and type III collagen at mRNA and protein levels (P < 0.05), enhanced wound healing rate (P < 0.05) as well as increasing the ratio of collagen type I/III starting from the 3rd day after operation (P < 0.05). To conclude, the vacuum sealing drainage can accelerate wound healing by up-regulating the protein expression of type I collagen and type III collagen, the ratio of collagen type I/III and increasing wound tensile strength.
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Objective: To preliminary explore the effect of decellularized adipose tissue (DAT) combined with vacuum sealing drainage (VSD) on wound inflammation in pigs. Methods: The DAT was prepared through the process of freeze-thaw, enzymatic digestion, organic solvent extraction, and vacuum freeze-drying. The appearance of DAT was observed before and after freeze-drying. HE staining was used to observe its structure and acellular effect. Eighteen male Bama minipigs were recruited, and four dorsal skin soft tissue wounds in diameter of 4 cm were made on each pig and randomly divided into 4 groups for different treatments. The wounds were treated with DAT combined with VSD in DAT/VSD group, DAT in DAT group, VSD in VSD group, and sterile gauze dressing in control group. HE staining was performed at 3, 7, 10, and 14 days after treatment. Moreover, the expressions of inflammatory factors [interleukin 1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α)], as well as the phenotypes of M1 and M2 macrophage phenotypic markers [inducible nitric oxide synthase (iNOS) and arginase 1 (ARG-1)] were detected by real-time fluorescence quantitative PCR (qRT-PCR). ELISA was used to determine the content of iNOS and ARG-1. Results: General observation and HE staining showed that DAT obtained in this study had a loose porous structure without cells. The neutrophils of wounds were significantly less in DAT/VSD group than in control group and DAT group ( P0.05) between DAT/VSD group and VSD group. And the neutrophils were significantly less in DAT/VSD group than in other three groups ( P<0.05) at 7, 10, and 14 days. The mRNA expressions of IL-1β, IL-6, TNF-α, and iNOS were significantly lower in DAT/VSD group than in other three groups at 3, 7, 10, and 14 days ( P<0.05), while the mRNA expression of ARG-1 was significantly higher in DAT/VSD group than in other three groups ( P<0.05). ELISA showed that the content of iNOS was significantly lower in DAT/VSD group than in other three groups at 3, 7, 10, and 14 days ( P<0.05), while the content of ARG-1 was significantly higher in DAT/VSD group than in other three groups ( P<0.05). Conclusion: DAT combined with VSD can significantly reduce inflammatory cell infiltration during wound healing, regulate the expressions of inflammatory factors and macrophage phenotype, and the effect is better than single use of each and conventional dressing change.
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Objective @#To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces.@*Methods@# Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied.@*Results@#Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital.@*Conclusion@#For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.
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OBJECTIVE@#To explore the clinical effect of vacuum sealing drainage (VSD) technique and Ointment in the treatment of foot skin defect.@*METHODS@#From November 2017 to April 2019, 21 patients (21 feet) with foot skin defect were treated with VSD technique and Ointment. There were 17 males and 4 females, aged from 24 to 60 years old with an average of (37.8±11.2) years, 9 cases caused by traffic accident injury, 6 cases by heavy injury, 6 cases by falling injury. The time from injury to operation was for 3 to 36 (8.6±7.2) h, and the area of foot skin defect was for 20.35 to 83.43(47.2±19.5) cm. All patients underwent debridement or phaseⅠtemporary fixation in emergency, and three-dimensional imagingof the foot was performed by using Mimics software, and the defect area was rendered. The quality of wound healing and complications were observed, and the clinical effect was evaluated by Maryland foot function score.@*RESULTS@#All the 21 patients were followed up for 7 to 17 (10.8±2.7) months. There was no infection or nonunion in all patients. At the final follow-up, the skin margin of the healing site grew tightly, the skin was elastic, the texture was tough, the appearance was no obvious carbuncle. The time of wound healing was for 18 to 63 (41.2±13.3) days. Eight patients underwent stageⅡfixation or/and fusion, and all incisions healed by stageⅠ. According to Maryland's foot scoring, 9 cases got excellent results, 11 good, and 1 middle.@*CONCLUSION@#VSD can effectively remove the necrotic tissue of the wound, provide a smooth drainage of the wound, combine with Ointment to prevent infection and promote the rapid growth of granulation tissue, whose whole treatment cycle was short, the wound healing site was highquality, the limb function was good, and the clinical effect was satisfactory.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Drainage , Negative-Pressure Wound Therapy , Skin Transplantation , Soft Tissue Injuries , General Surgery , Treatment OutcomeABSTRACT
The incidence of primary cutaneous Mycobacterium intracellulare infection is very low. We report a case of primary cutaneous M. intracellulare infection which presented as painful erythematous swelling of the right upper limb without systemic involvement. A novel technique of vacuum sealing drainage was successfully implemented after antimycobacterial treatment proved ineffective at the end of 3 months. Our technique also revealed some additional practical advantages.
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Objective To examine the impact of vacuum sealing drainage on clinical outcomes of patients with post-sternotomy mediastinitis after cardiac surgery. Methods A systematic search were performed in Cochrane Library, Pubmed, Embase, China Biology Medicine(CBM), WanFang, VIP database. The quality of articles was critically appraised and data were extracted by 2 reviewers independently. Meta-analysis were conducted for the eligible researches. Results Fourteen cohort studies were inclued finally. Patients treated with VSD had significantly lower in-hospital mortalityand lower re-infection compared to those treated without VSD. While there had no significant defferences in length of ICU stay(days) and in-hospital stay (days) between VSD group and control group. Conclusions VSD therapy was associated with lower re-infection and in-hospital mortality than other conventional methods in patients with post-sternotomy mediastinitis after cardiac surgery and those results should be further tested in future research and practice.
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OBJECTIVE@#This study aims to observe the efficacy of vacuum sealing drainage (VSD) by continuous negative pressure drainage and saline irrigation in the treatment of oral and maxillofacial space infection.@*METHODS@#Retrospective analysis was conducted on 116 cases of maxillofacial space infection, and clinical data were collected to compare the therapeutic effects of routine incision with drainage treatment (traditional treatment group, 58 cases) and VSD treatment (VSD group, 58 cases).@*RESULTS@#The length of hospital stay, white blood cell count, scar length, frequency of dressing change, and pain degree of patients in the VSD group were all lower than those in the traditional treatment group. Moreover, the improvement degree of mouth opening in the VSD groups was better than that in the traditional treatment group (P<0.05).@*CONCLUSIONS@#VSD is a more effective method for the treatment of oral and maxillofacial space infection.
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Humans , Body Fluids , Drainage , Mouth Diseases , Therapeutics , Retrospective Studies , Surgical Wound Infection , Therapeutics , VacuumABSTRACT
Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
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Humans , Abdomen , General Surgery , China , Drainage , Methods , Evidence-Based Medicine , Practice Guidelines as Topic , Societies, Medical , Surgical Wound Infection , Traumatology , VacuumABSTRACT
When severe diabetic foot gangrene occurs, the surgical incision is often difficult to heal due to poor blood supply of distal limbs and severe local infection. The method of moist?expose?burn?ointment? (MEBO) combined with vacuum sealing drainage was applied to the wound of diabetic foot after amputation. The wound of 8 patients with diabetic foot after amputation was completely healed, the wound was repaired well, and the length of limb was retained to a large extent, and the function of affected limb was restored well.
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When severe diabetic foot gangrene occurs, the surgical incision is often difficult to heal due to poor blood supply of distal limbs and severe local infection. The method of moist?expose?burn?ointment?(MEBO) combined with vacuum sealing drainage was applied to the wound of diabetic foot after amputation. The wound of 8 patients with diabetic foot after amputation was completely healed, the wound was repaired well, and the length of limb was retained to a large extent, and the function of affected limb was restored well.
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Objective To measure the oxygen partial pressure (PtO2) within a situation of vacuum sealing drainage (VSD) implement, and to discuss the potential mechanism of VSD alleviating skeletal muscle ischemia reperfusion (I/R) injury in rabbits. Methods Rabbits were randomly(random number) divided into three groups: sham (n=10), I/R (n=10) and I/R+VSD (n=10) groups. In the I/R group, left hind limb ischemia was induced by clamping the femoral artery and vein for 4 h, then released for 6 h, to allow reperfusion of the limb. VSD was only performed in the I/R+VSD group during the reperfusion period. All rabbits were administered a series test of PtO2 in different time points before and after reperfusion, and the left hind limb skeletal muscle and ear vein blood samples were immediately harvested for biochemical analyses, including hypoxia inducible factor 1 alpha (HIF-1α) mRNA and protein, and lactic acid (LA). One-way analysis of variance (ANOVA), Fisher's least significant difference (LSD) test or Tamhane's T2 test was used where appropriate to analyze the experimental results. Results The levels of PtO2 in the I/R and I/R+VSD groups were decreased after ischemia, but no significant difference was noted between the two groups (t=1.322, P=0.296). The PtO2 levels in the I/R+VSD group were less increased than those in the I/R group after reperfusion (t=2.015, P=0.046). The levels of HIF-1α mRNA and protein were increased after I/R injuries (F=10.120, P=0.002; F=36.480, P<0.01; F=6.960, P=0.015, F=4.470, P=0.035), and the levels in the I/R+VSD group were greater than those in the I/R group (t=1.799, P=0.048, t=5.911, P=0.019; t=1.878, P=0.046, t=2.609, P=0.030). The LA levels were significantly increased in the skeletal muscle and blood samples in the I/R and I/R+NPWT groups compared with those in the sham group at the final stage (F=9.540, P=0.002 and F=13.750, P<0.01), but the levels in the I/R+VSD group were less than those in the I/R group (t=2.263, P=0.040 and t=3.617, P=0.027). Conclusions Our results suggested that VSD technique decreased PtO2 in regional ischemic muscles and led to increases in HIF-1α mRNA and protein that subsequent accumulation of less LA in both of regional skeletal muscle and systemic blood circulation, which provided protection effect after I/R injury in rabbits.
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Objective To investigate the effect of ultrasound debridement combined with vacuum sealing drainage on the treatment of diabetic foot ulcer and the potential mechanism. Methods Eighty-one patients with diabetic ulcer were randomly divided into two groups:ultrasound debridement combined with vacuum sealing drain-age as the experimental group,routine debridement combined with vacuum sealing drainage as the control group. The clinical curative effect,the reduction rate of the wound,the rate of blastocyst and the rate of bacterial clear-ance and blood flow were detected.Results The clinical curative effect in the experimental group was significantly better than that in the control group(P < 0.05). The rates of wound reduction and granulation were significantly higher than those in the control group(P<0.05).After 14-day treatment,the blood perfusion in the experimental group was significantly higher than that in the control group(P<0.05),and the expression of HIF-1α and VEGF in the ulcer tissue was significantly higher than that in the control group(P<0.05).Conclusions Ultrasound de-bridement combined with vacuum sealing drainage can improve the clinical efficacy,wound reduction rate,granu-lation coverage rate and bacterial clearance rate,and increase ulcer tissue blood flow. The potential mechanism is related with the increases of HIF-1α and VEGF in ulcer tissue.
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Objective To explore the application value of vacuum sealing drainage (VSD) in wound repair after resection of pilonidal sinus.Methods The retrospective cross-sectional study were conducted.The clinical data of 11 patients with pilonidal sinus who were admitted to the China-Japan Union Hospital of Jilin University from April 2015 to June 2016 were collected.All the patients received resection of pilonidal sinus after preoperative antibiotic therapy,and then received postoperative VSD and regular treatments of anti-infection and dressing changes.Observation indicators:(1) treatment situations:surgical procedures,operation time,volume of intraoperative blood loss,gross specimens,results of postoperative pathological examination,postoperative treatment (VSD),growth condition of granulation tissue,duration of hospital stay and treatment expenses;(2) follow-up situations:cases with follow-up,follow-up time,wound healing,postoperative complications and disease recurrence.Follow-up using outpatient examination and telephone interview was performed to detect the wound healing,postoperative complications and disease recurrence up to July 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M(range).Results (1) Treatment situations:all the 11 patients underwent successful surgery for pilonidal sinus.The operation time and volume of intraoperative blood loss were respectively (79 ± 19) minutes and (10 ± 4) mL.Observation of gross specimens of 11 patients:hairs were scattered within the resected lesions in 7 patients,and hairs didn't found in 4 patients.Results of postoperative pathological examination of 11 patients:there were acute and chronic inflammation accompanied with granulation tissues in the subepithelial fibrous tissues,and discrete multinucleated giant cell reaction.Of 11 patients undergoing VSD,9 received VSD material changes for 3 times,2 received VSD material changes for once,and wounds were not sutured after VSD removal.The new granulation tissues of 11 patients were found at (5.9±1.3) days postoperatively.The duration of hospital stay and treatment expenses were respectively (33.3±8.3) days and (37 790± 8 811) yuan.(2) Follow-up situations:11 patients were followed up for 12-18 months,with a median time of 14 months.The wound healing time was (41.0±9.0)days.Of 11 patients with follow-up,10 were in the primary healing,1 who was complicated with wound infection and abscess of wound deep surface underwent sacral wound incision and drainage,gauze packing and routine dressing change,and then wound healed completely.There was no recurrence in 11 patients during the follow-up.Conclusions The VSD has great application value in managing wounds after resection of pilonidal sinus,with a lower incidence of wound infection and smaller scar,and it is worth recommending to patients with wide wounds,high tension and serious infection.
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Objective To explore the effect of traditional incision and drainage combined with vacuum sealing drainage (VSD)in treating patients with purulent exudation-staged genual septic arthritis. Methods The patients with purulent exuda-tion-staged genual septic arthritis were selected in the Zhengzhou Orthopedics Hospital from January 2010 to December 2015, and they were divided into control group and observation group. Fifty-four patients in the control group were treated with open operative drainage,while fifty patients in the observation group were treated with open operative drainage combined with VSD. The operation time,intraoperative bleeding volume,tourniquet application time,washing time,antibiotic use time,hospitalization time,therapeutic effect and relapse rate were compared between the two groups. Results There was no statistical difference in operation time and tourniquet application time and intraoperative bleeding volume between the two groups(t = - 0. 216,2. 518, 11. 320;P > 0. 05). Compared with the control group,the antibiotic use time and hospitalization time were shorter,the washing time was longer in the observation group(t = 2. 270,- 46. 310,2. 518;P < 0. 05). The occurrence rate of postoperative compli-cations in the control group and the observation group was 9. 3％(5 / 54)and 6. 0％(3 / 50),there was no statistical difference in the occurrence rate of postoperative complications between the two groups(χ2 = 0. 331,P > 0. 05). The fineness rate in the control group and the observation group was 25. 9％(14 / 54)and 22. 0％(11 / 50),there was no statistical difference in the fineness rate between the two groups(χ2 = 0. 219,P > 0. 05). The relapse rate in the control group and the observation group was 33. 3％(18 / 54)and 8. 0％(4 / 50),the relapse rate in the observation group was lower than that in the control group (χ2 =0. 331,P <0. 05). Conclusion Traitional incision and drainage combined with VSD has advantages of shortening hospital-ization and intravenous antibiotic time and decreasing relapse rate in treating purulent exudation-staged genual septic arthritis.
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Objective To investigate the effect of section of pancreatic envelope combined with vacuum sealing drainage under laparoscopy on inflammatory mediators of patients with early severe acute pancreatitis (SAP). Methods Forty-two SAP patients were admitted to Foshan Hospital of Traditional Chinese Medicine in Guangdong Province from January 2008 to December 2016. That 22 patients underwent pancreatic membrane incision and vacuum sealing drainage under laparoscopy was in the experimental group, and that 20 patients underwent the routine pancreatic membrane incision and double tube drainage was in the control group. The venous blood was collected, the levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured before and after operation for 1, 3, 7 and 14 days, and the clinical therapeutic effects were observed in the two groups. Results With the prolongation of therapy, the levels of CRP, IL-6 and TNF-α were decreased continuously in both groups, the degrees of decrease of above indexes in experimental group were more significant than those in the control group, and the differences in these indexes between the two groups were statistically significant [CRP (mg/L): 1 day was 203.80±25.12 vs. 271.79±60.41, 3 day was 117.26±19.70 vs. 174.53±42.37; IL-6 (ng/L): 1 day was 40.63±3.38 vs. 57.10±11.46, 3 days was 23.14±3.51 vs. 46.87±10.69; TNF-α (ng/L): 1 day was 23.91±10.42 vs. 36.73±15.90, 3 days was 19.13±8.34 vs. 32.58±15.81, all P < 0.05]. There were no statistical significant differences in the levels of above indexes on 7 days and 14 days after treatment between the two groups (all P > 0.05). The therapeutic efficacy of the experimental group was significantly higher than that of the control group [95.45% (21/22) vs. 90.0% (18/20), P < 0.05]. Conclusion Under laparoscopy, pancreatic envelope incision combined with vacuum sealing drainage performed for early SAP patients can control the body inflammation more rapidly, reduce complications and shorten the disease course.
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This article introduces the combined application of vacuum sealing drainage (VSD) and chymotrypsin in the treatment of post-operative mandibular osteomyelitis. The lesion was washed by chymotrypsin (4000U) and saline (500 ml). VSD is effective in the treatment of traumatic mandibular osteomyelitis. This study investigates the effect of VSD combined with chymotrypsin in the treatment of patients with osteomyelitis after mandibular trauma. It is proved that it has a good effect in ensuring drainage, controlling infection and retaining internal fixation, and can create a good environment for fracture healing.
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Objective: To evaluate the clinical value of skin stretching device in repair of diabetic foot wound. Methods: A retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n=24) and with the vacuum sealing drainage combined with skin graft (control group, n=24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups ( P>0.05). Both patients in 2 groups were treated with sensitive antibiotics according to the results of bacterial culture. Results: One case in control group was infected and the skin graft failed, and 1 case in trial group was infected after the treatment, and the two wounds healed after symptomatic treatment. The wounds of the other patients healed successfully, and the healing time of the trial group was significantly shorter than that of the control group [(12.8±11.6) days vs. (22.3±10.4) days; t=2.987, P=0.005). All patients were followed up 3-12 months after operation, and no wound dehiscence or recurrence occurred during follow-up. Conclusion: Compared with the vacuum sealing drainage combined with skin graft, the application of skin stretching device in the repair of diabetic foot wound has advantages, such as easy to operate, shorten the wound healing time, and the appearance of wound was similar with the adjacent skin.