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Published on: February 26, 2015
Sequential therapy with "vacuum sealing drainage-artificial dermis implantation-thin partial thickness skin grafting"
1Children's Hospital of Chongqing Medical University, Department of Burns and Plastic Surgery, No. 136, Zhongshan 2nd Road, 400014 Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing (CSTC2009CA5002), Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China.
Insights
This study shows that sequential vacuum sealing drainage (VSD) with artificial dermis implantation (ADI) and thin partial thickness skin grafting (TSG) is an effective treatment for deep, infected pediatric wounds, leading to better graft outcomes.
Area of Science:
- Pediatric surgery
- Wound healing
- Regenerative medicine
Background:
- Deep and infected wounds in children pose significant treatment challenges.
- Current treatments often involve multiple procedures and may result in suboptimal outcomes.
Purpose of the Study:
- To evaluate the efficacy of a novel sequential therapy for deep and infected pediatric wounds.
- To compare this new approach with traditional methods.
Main Methods:
- A cohort of 53 pediatric patients received sequential vacuum sealing drainage (VSD), artificial dermis implantation (ADI), and thin partial thickness skin grafting (TSG).
- Outcomes were compared to a control group of 20 patients treated with surgical debridement, dressing changes, and TSG.
- Graft survival, tissue characteristics (color, flexibility, fullness), and scar formation were assessed.
Main Results:
- The sequential VSD-ADI-TSG therapy effectively reduced tissue necrosis and infection while promoting granulation tissue growth.
- Skin grafts on artificial dermis exhibited improved smoothness, glossiness, and elasticity compared to controls.
- Significantly lighter scarring was observed in the VSD-ADI-TSG group based on the Vancouver Scar Scale.
Conclusions:
- Sequential VSD-ADI-TSG therapy offers a simple and effective treatment option for complex pediatric wounds.
- This approach enhances graft quality and reduces scar severity.
Objective:
To evaluate the efficacy of a "vacuum sealing drainage (VSD) - artificial dermis implantation (ADI) - thin partial thickness skin grafting (TSG)" sequential therapy for deep and infected wounds in children.
Materials And Methods:
Fifty-three pediatric patients with deep and infected wounds were treated with sequential VSD-ADI-TSG therapy. The efficacy of this treatment was compared with that of the surgical debridement-change dressings-thin partial thickness skin grafting previously performed on 20 patients. Survival of tissue grafts, color and flexibility, subcutaneous fullness and scar formation of the graft site were examined and compared.
Results:
The sequential therapy combined the advantages of the VSD treatment, in reducing tissue necrosis and infection on the wound surfaces and promoting the growth of granulation tissue, with the enhancement of grafting by artificial dermis. Compared with the 20 controls, skin grafted on the artificial dermis was more smooth and glossy, while the textures of the region were more elastic, and the scars were significantly lighter in Vancouver scale.
Conclusion:
The sequential VSD-ADI-TSG therapy is a simple and effective treatment for children with deep and infected wounds.
Level Of Evidence:
IV.
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