[Analysis of vacuum sealing drainage complications during treatment of extremity wounds].

OBJECTIVE: To investigate the causes of the vacuum sealing drainage (VSD) complications during treatment of extremity wounds.

METHODS: Between February 2005 and February 2010, 174 patients with skin and soft tissue defect of extremities were treated with VSD. Among them, 12 patients (6.9%) had complications and the clinical data were analyzed retrospectively. There were 7 males and 5 females aged from 17 to 65 years (mean, 36.1 years). Injury was caused by traffic accident in 8 cases, and by machine extrusion in 4 cases. The locations were forearm in 3 cases, upper arm in 2 cases, thigh and calf in 1 case, calf in 4 cases, and foot in 2 cases. The size of defect ranged from 10 cm x 7 cm to 90 cm x 40 cm. The time from injury to hospitalization was 3-8 hours (mean, 4.2 hours).

RESULTS: At 1 day postoperatively, moderate to severe anemia and hypokalemia occurred in 6 cases, and the hemoglobin value increased to 100 g/L and the electrolyte disorder was rectified after blood transfusion and fluid infusion. At 2 days, 2 patients had local skin allergic symptoms, and local rash disappeared after oral administration of Clarityne. At 3 days, 2 patients complained pain and the pain was released after the suction pressure was decreased by 50%; 2 patients had infection and received VSD demolition, debridement and draining, and anti-infection treatment. Tissue necrosis occurred in 1 case at 4 days and pressure ulcer in 1 case at 5 days, VSD was immediately changed and wound was repaired by split thickness skin graft or local flap.

CONCLUSION: Complications associated with VSD therapy for the wounds of the extremities are not very common. Most causes are related to the location of wound, the technique of the operators, and the conditions of the patients.