• J Orthop Sci · Sep 2019

    Comparative Study

    The management of degloving injuries of the limb with full thickness skin grafting using vacuum sealing drainage or traditional compression dressing: A comparative cohort study.

    • Kaizong Yuan, Bin Zhao, Tokai Cooper, Zeyuan Jin, Xijie Zhou, Xinglong Chen, Zhijie Li, Weiyang Gao, and Hede Yan.
    • Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China. Electronic address: 513740828@qq.com.
    • J Orthop Sci. 2019 Sep 1; 24 (5): 881-887.

    BackgroundDegloving injuries of the limb are severe and frequently underrated. Few researches are available comparing the results of reattachment of the degloved skin grafts with the vacuum sealing drainage technique and the traditional compression dressing method. In this study, we aimed to compare the treatment outcomes of these two approaches.MethodsEighty-three consecutive patients were treated for degloving injury of the limb. Based on the treatment approach, the patients were divided into vacuum sealing drainage group (VSD group, n = 55) and traditional compression dressing group (TCD group, n = 28). After reattachment, the degloved skin was secured with stitches and compressed with VSD or TCD. The outcomes were mainly assessed based on the percentage of skin graft take.ResultIn VSD group, there were excellent results in 18, fair in 9 and poor in 28, respectively; In TCD group, there were excellent results in 11, fair in 10 and poor in 7, respectively. Statistically, no significant difference was found between two groups in terms of the category of excellent results. However, significant higher incidence of poor results with necrotic areas exceeding 50% was observed in the VSD group than that in the TCD group. In addition, although the duration of hospitalization in the VSD group was shorter than that in the TCD group, the medical supply costs and total costs were much higher than that of the TCD group.ConclusionVSD and TCD are equally effective in the management of degloving injuries of the limb; however, VSD technique may potentially have a higher risk of poor results with increased hospital charges. The traditional approach still has its merits in clinical practice, especially in rural hospitals when VSD is not available or unaffordable.Copyright © 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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