Effect of dynamic regulation of negative pressure values in vacuum sealing drainage on healing of soft tissue wounds / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the effect of dynamic regulation of negative pressure values in vacuum sealing drainage (VSD) on healing of soft tissue wounds.Methods From January 2013 to December 2015,115 patients were treated at our institute for open soft tissue defects of Gustilo-Anderson type ⅢaⅢc.They were 69 males and 46 females,aged from 17 to 76 years (average,44.7 years).They were divided into 4 groups to be subjected to different negative pressure values.Group A (n =29) was subjected to negative pressure values from-40 to-20 kPa,group B (n =29) to values from-80 to-60 kPa,group C (n =29) to values from-40 to-20 kPa for the first 72 hours followed by values from-80 to-60 kPa,and group D (n =28) to values from-60 to-80 kPa for the first 72 hours followed by values from-40 to -20 kPa.The 4 groups were compared in terms of drainage volume,wound shrinking,cleaning time,healing time and complications.Results The drainage volumes on the 7th day in groups B and D (4.89 ± 0.66 mL/cm2 and 4.33 ± 0.96 mL/cm2) were significantly higher than those in groups A and C (2.90 ± 0.67 mL/cm2 and 2.99 ±0.56 mL/cm2);the wound shrinking areas on the 14th day in groups B and D (14.16 ± 1.77 cm2 and 13.84 ± 1.65 cm2) were significantly larger than in groups A and C (12.57 ± 1.92 cm2 and 10.95 ± 1.37 cm2) (P ＜ 0.05).The cleaning time in group A was significantly longer than in the other 3 groups (P ＜ 0.05).The healing time in groups A and C was longer than in groups B and D (P ＜ 0.05).The incidences of pain in groups B and C were significantly higher than in groups A and D (P ＜ 0.05).The incidences of infection and blocking in group A were higher than in the other 3 groups (P ＜ 0.05).Conclusion Dynamic regulation of negative pressure values from-80 to-60 kPa for the first 72 hours followed by values from-40 to-20 kPa is an optimal choice for VSD management of soft tissue defects due to adequate drainage,obvious wound shrinking,quick cleaning and healing,and limited complications.