Preoperative irrigation and vacuum sealing drainage with antibiotic-containing drainage fluid of foot and ankle wounds improves outcome of reconstructive skin flap surgery

Abstract

ObjectivesBy observing the infection and soft tissue defect on the wound surface of the foot and ankle, this paper attempts to explore the effect of preoperative irrigation and vacuum sealing drainage with antibiotic-containing drainage fluid (abPI-VSD) on the bacterial quantity and the local inflammatory response at the flap, and further to provide a basis for applying this technique before a reconstructive skin flap surgery of foot and ankle wounds.MethodsSeventy-five patients were randomly divided into two groups, and all surgeries were done by one physician. The flap reconstructions were done to 31 cases with the abPI-VSD being used (group A); the flap reconstructions were done to the rest 44 cases after wound cleaning using antibiotic irrigation solution without the use of the abPI-VSD (group B). Quantitative bacteriology was made to group A before and after the use of abPI-VSD; quantitative bacteriology was made to group B before and after wound cleaning. Then, the reconstructive skin flap surgery was done. After the surgeries, the time of local inflammatory response at the flap in both groups were recorded. The measured bacterial quantity was evaluated in logarithm and by t test.ResultsThe bacterial quantity was 3.2 ± 1.9 × 107 cfu/g in group A before the use of abPI-VSD and 2.3 ± 2.0 × 107 in group B (P > 0.05) before debridement. The bacterial quantity was 1.2 ± 2.0 × 104 cfu/g in group A after abPI-VSD and was 2.9 ± 4.0 × 106 in group B after wound cleaning (P < 0.05). The time of postoperative inflammatory response in the flap was 8 ± 2.5 days in group A and 13 ± 3.4 days in group B (P < 0.05).ConclusionsabPI-VSD can distinctly reduce the bacterial quantity on the surface of the wound, provide a good condition of tissue bed for the flap reconstruction, and effectively control the local inflammatory response at the flap and hence improve the survival quality of the flap.

Effect of vacuum sealing drainage on healing time and inflammation‐related indicators in patients with soft tissue wounds

“…The application of VSD could reduce oedema and inflammation in wounds, which accelerates the healing of wounds. Because of the above advantages, the technique has been prevalent in the treatment of chronic wounds like postoperative incision infection, soft‐tissue cleft, open fracture or infection, ulcers, acne, purulent infection of body surface or joint cavity, and skin graft 14‐17 . Although VSD has certain clinical advantages in the treatment of soft tissue of traumatic wounds, most of the studies were retrospective analyses, and the observation indicators were not comprehensive.…”

“…Because of the above advantages, the technique has been prevalent in the treatment of chronic wounds like postoperative incision infection, soft‐tissue cleft, open fracture or infection, ulcers, acne, purulent infection of body surface or joint cavity, and skin graft. 14 , 15 , 16 , 17 Although VSD has certain clinical advantages in the treatment of soft tissue of traumatic wounds, most of the studies were retrospective analyses, and the observation indicators were not comprehensive. Therefore, this prospective cohort study was designed to investigate the effects of VSD on the wound repair time and inflammation‐related indicators in patients with soft‐tissue wounds.…”

Clinical application of posterior tibial artery or peroneal artery perforator flap in curing plate exposure after ankle fracture fixation

“…The unique anatomical structure of the ankle, featuring relatively poor vascular supply compared to other joints, exacerbates the risk of complications 14,15 . These risks become especially pronounced if the fracture is accompanied by skin abrasions or open wounds, which may lead to bacterial biofilm formation, chronic infections and non‐healing wounds 7,16 …”

“…14,15 These risks become especially pronounced if the fracture is accompanied by skin abrasions or open wounds, which may lead to bacterial biofilm formation, chronic infections and non-healing wounds. 7,16 To tackle these challenges head-on, various flap repair techniques are implemented, including posterior tibial artery perforator flaps, peroneal artery perforator flaps, cross-leg flaps and free anterolateral thigh flaps. 17,18 Each of these flaps has distinct pros and cons.…”

Vacuum sealing drainage system combined with an antibacterial jackfruit aerogel wound dressing and 3D printed fixation device for infections of skin soft tissue injuries

“…Closed dressings isolate the wound from the surrounding environment and effectively prevent the wound from being contaminated and infected [ 4 ]. At present, VSD has also achieved relatively good results in various clinically refractory skin diseases, soft tissue injuries, and skin grafting [ 5 , 6 ]. However, infectious necrotic tissue may be adsorbed on spongy suction materials with a negative pressure, resulting in blockage [ 6 ].…”