[Early use of vacuum sealing drainage to repair the wound of the injured in Wenchuan earthquake].

OBJECTIVE

To investigate the method of using vacuum sealing drainage (VSD) technique to repair the wound of the injured in Wenchuan earthquake and its therapeutic effect.

METHODS

From May 12, 2008 to June 12, 2008, 52 injured persons (83 wounds) were treated, including 27 males and 25 females aged 11-83 years old (average 42 years old). There were 22 cases of crush injury, 9 cases of contusion and laceration injury, 17 cases of compression injury receiving incision decompression of fascia compartment and 4 cases of open amputation. And 37 wounds were on the leg, 13 wounds on the thigh, 17 wounds on the forearm, 11 wounds on the upper arm and 5 wounds on the trunk. The wound ranged from 3 cm x 2 cm to 30 cm x 15 cm, and the time from injury to undergoing VSD treatment was 12 hours-18 days. After complete debridement, the wound was covered by VSD dressing, and antibiotics were given according to the result of drug sensitive test. When wound infection was under control and granulation tissues grew well, the method of either direct suture or skin grafting or flap transposition was used to repair the wounds.

RESULTS

In 21 cases (40.4%), wound secretion smear was positive, and multiple species of bacteria were detected, such as Staphylococcus aureus, Escherichia coli, Proteus and Klebsiella pneumoniae. After initial operation, 7 injured persons were transferred to the hospital outside of Sichuan province for further treatment. VSD treatment was performed on 33 cases (45 wounds) once, 6 cases (10 wounds) twice, 2 cases (3 wounds) three times and 1 case (1 wound) four times, resulting in the control of wound infection and the growth of granulation tissue. Then the wounds were repaired by either direct suture or skin grafting or flap transposition. Three cases (4 wounds) underwent VSD treatment ten times, leading to the control of infection and the stability of condition.

CONCLUSION

VSD treatment can cover the wound promptly, eliminate contamination, prevent secondary infection and benefit late-stage wound repair. During the process of treatment, no medical necessity for frequent change of dressing can relieve the pain suffered by the injured and decrease the workload of medical stuff, thus facilitating the rescue work.