ObjectiveTo summarize the nursing experience of vacuum-assisted closure (VAC) technology for deficiency of skin and soft tissue in "4·20" earthquake damage. MethodsWe used VAC to treat 20 patients suffering from deficiency of skin and soft tissue who were injured in "4·20" earthquake (35 wounds) from April 21st to 28th, 2013; and we observed closely the results of nursing for pain and psychological care. ResultsA total of 35 wounds were all cleaned after 5 to 7 days; 20 wounds were healed after VAC treatment; 15 wounds recovered well by covering autogenous split-thickness skin; 20 patients had stable emotion and all left the hospital with the recovery. ConclusionVAC for deficiency of skin and soft tissue caused by "4·20" earthquake damage may obviously decrease the time of wound healing, relieve the pain caused by changing fresh dressing, and reduce the length of stay in the hospital.
Objective To observe the effectiveness of disposable skin stretch closure in the treatment of wounds with skin and soft tissue defects that were difficult to close. Methods The clinical data of 13 patients with skin and soft tissue defects that were difficult to close treated with disposable skin stretch closure and met the selection criteria between July 2021 and February 2022 were retrospectively reviewed. There were 9 males and 4 females, the age ranged from 15 to 71 years with a mean of 39.8 years. The causes of injury included falling injury in 5 patients, traffic accident injury in 5 patients, and falling from height injury in 3 patients. The causes of skin soft tissue defects included open fractures in 4 patients, wound infection in 4 patients, osteomyelitis in 3 patients, degloving injury in 1 patient, and necrosis of skin graft in 1 patient. The injury was located at calf in 8 patients, calcaneus in 3 patients, pelvis in 1 patient, and plantar in 1 patient. The skin and soft tissue defects ranged from 5.0 cm×2.0 cm to 10.5 cm×6.5 cm. Wound conditions (wound closure and wound healing) and the presence or absence of complications were recorded. Results All 13 patients were followed up 32-225 days with a median of 164 days. The wound closure time ranged from 5 to 14 days, with a mean of 8.8 days. The wound closure speed ranged from 0.7 to 13.7 cm2/day, with a mean of 3.6 cm2/day. All wounds healed at grade A, and no complication such as skin edge injury, wound necrosis, infection, dehiscence, and edema occurred. No patient complained of pain or discomfort, and no obvious scarring was found during follow-up. The wound healing time ranged from 17 to 28 days, with a mean of 21.7 days. One of them was transferred to other department due to lung cancer condition changes after using disposable skin stretch closure, and the wound had directly healed without suturing at 17 days after operation. Conclusion The effectiveness of disposable skin stretch closure in the treatment of wounds with skin and soft tissue defects that were difficult to close was exact, with short wound closure time, few complications, and easy operation.
Objective To investigate the therapeutic effect of medial sural artery perforator flap in the repair of small and medium size skin and soft tissue defects in the ipsilateral lower extremities. Methods The clinical data of patients with small and medium area skin and soft tissue defects of lower limbs admitted to Restorative and Reconstructive Department, NO.1 Orthopedics Hospital of Chengdu between September 2021 and January 2023 was retrospectively analyzed. Basic information of patients was collected. The anatomical characteristics, application methods, and clinical results of the flap were recorded after operation, and the comprehensive efficacy evaluation table of the flap was used to evaluate the clinical efficacy at the last follow-up. Results A total of 13 patients were included. There were 12 males and 1 female. A total of 19 perforating branches of medial sural artery were found in the 13 cases, with an average of 1.46 perforating branches. The incision range of the flap was 5.5 cm×3.5 cm−13.5 cm×5.0 cm. Anterograde pedicle metastasis occurred in 3 cases and free transplantation occurred in 10 cases; mosaic flaps were used in 5 cases, lobed flaps in 1 case, and conventional perforator flaps in the remaining 7 cases. All the flaps survived successfully. All the 13 patients were followed up for 4-15 months, with an average of (10.38±3.64) months. The comprehensive score of flap efficacy was 77-92 points, with an average of (86.76±4.45) points. Among them, 5 cases were excellent, 8 cases were good, and the excellent and good rate was 100%. Conclusion The multifunctional features and flexible use of medial sural artery perforator flap increase the repair strategy of small and medium-sized wounds of the ipsilateral lower limbs, and can obtain better aesthetic repair results.