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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 June;63(3):185-91
Clinical results of vacuum sealing drainage combined with sural nerve flap for soft tissue defect
Li-W., Meng G.-Q., Bi Z.-G.
Department of Orthopedic Surgery, The Fourth Affiliated Hospital, Harbin Medical University, Harbin City, Heilongjiang Province, China
Aim. The sural nerve flap failure is still a problem for the patient with reconstructive surgery. The cause were attributed to infection, tension and insufficient debridement. Negative pressure when applied to soft tissue defects results in a significant increase ingranulation tissue production compared to similar conventionally treated wounds in the patients. There were no clinical signs of infection and cultures were negtive in any of the wounds that achieved complete closure.
Methods. We used vacuum sealing drainage (VSD) combined with sural nerve flap for the reconstruction of defects of lower one-third of the leg, foot and ankel.with exposed tendon or bone in 25 patients between 2007 and 2009. The defects were covered with no major complications.
Results. All 25 flaps survived after the operation. The blood supply and venous return of the skin flaps were good. In 2 flaps, there was a small amount of distal marginal necrosis, which was excised and closed spontaneously or skin grafted. Slight venous congestion of the flap occurred in one patients, which were cured by removing some sutures. No other clinical abnormalities were discovered. Mean follow-up was 17 months (5-24 months). The flap was warm, and no venous congestion was observed.
Conclusion. We concluded that the vacuum sealing drainage combined with sural nerve flap can be recommended for the treatment of acute traumatic soft tissue defects and for soft tissue defects complicated by exposed bone and /or implants.