Effects of vacuum sealing drainage on the treatment of cranial bone-exposed wounds in rabbits

This study was designed to assess the efficacy of vacuum sealing drainage (VSD) on skull exposure wounds in rabbits and to investigate the underlying mechanism of the process. Full-thickness excisional circular wounds 2×2 cm with or without periosteum involvement were created in 88 New Zealand white rabbits (mean body weight: 3.0±0.65 kg). Animals were randomly divided into 4 groups: periosteum-intact wounds treated with traditional dressing (p+control), periosteum-intact wounds treated with VSD (p+VSD), periosteum-lacking wounds treated with traditional dressing (p-control) and periosteum-lacking wounds treated with VSD (p-VSD). The wounds treated with traditional dressing were covered with Vaseline gauze, while VSD treatment was accompanied with continuous -120 mmHg pressure. Finally, wound tissues were harvested for analysis of hydroxyproline content and histologic detection. VSD hastened the wound healing process significantly (P<0.05) compared to the corresponding control groups. VSD alleviated the inflammation reaction, accelerated re-epithelialization and facilitated the organization of collagen fibers into neat rows. During the wound healing process, the hydroxyproline content increased overtime [i.e., postoperative days (POD) 7, POD 10 and POD 15] in all four groups, and it peaked in the p+VSD group. VSD also promoted angiogenesis via increasing number and quality of collagen. We concluded that VSD can promote healing in bone-exposed wounds via increasing hydroxyproline content and vessel density, reducing inflammatory responses and generating ordered collagen arrangement.

Curative effect of epluchage combined with vacuum sealing drainage and topical oxygen therapy on chronic bone exposed wounds / 局解手术学杂志

Objective To explore the therapeutic effect of epluchage combined with vacuum sealing drainage and topical oxygen therapy in the treatment of chronic bone exposed wounds.Methods Thirty-two patients with chronic bone exposed wounds were enrolled in this study from December 2014 to January 2017.All these patients were treated by epluchage combined with vacuum sealing drainage and topical oxygen therapy.Observed the growth and healing time,bacteriology changes,and related preoperative imaging studies of the wounds.Results The X-ray examination showed that there were 14 cases of decrease of the local bone density,disappearance of normal bone structure,and thickening of the outer membrane;10 patients with local defects of bone cortex and cancellous;4 cases of bone density increase;and 4 cases of periosteal reaction with different degree and unclear bone tissue damage.After epluchage combined with vacuum sealing drainage and topical oxygen therapy,granulation tissue of all the 32 cases grew rapidly,and the bone exposure areas were quickly covered.Wound secretions and exudate were significantly reduced,and the wounds were crued after several dressing change,without any postoperative infection.The healing time was 16 to 30 days,with the average time of (23.6±3.6)days.After being followed-up for 6 to 12 months,it was showed that the wound healed well without ulceration and recurrence.Secretions examination showed that there were 20 cases of secretions bacterial cultured to negative,while there were 6 cases of staphylococcus aureus and 6 cases of staphylococcus epidermidis.Conclusion On the basis of definite lesion range,remove the lesions dead bone through epluchage and cure the chronic bone exposed wounds with postoperative vacuum sealing drainage and topical oxygen therapy can significantly shorten the wound healing time and avoid recurrence.