Lei Ying, Liu Lei, Du Si-Heng, Zong Zhao-Wen, Zhang Lian-Yang, Guo Qing-Shan
Center of Trauma Surgery, Daping Hospital, The Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing, 400042, China.
J Med Case Rep. 2018 Sep 3;12(1):264. doi: 10.1186/s13256-018-1779-8.
This case report presents the treatment of a large infected skin defect, which was caused by an accidental explosion, through a skin-stretching device combined with vacuum sealing drainage. To the best of our knowledge, the area of the wound that we treated may currently be the largest.
A 41-year-old Asian man was transferred to the Center of Trauma Surgery of our hospital for the closure of an open infected wound with a large skin defect in his right lower limb caused by an accidental explosion of 100 pieces of blasting cap. The wounds located in his right gluteal were approximately 40 cm × 35 cm. On admission, the wounds had hemorrhaged, exhibiting a darkened appearance, and included scattered metallic foreign bodies. Debridement of his right gluteal area was conducted 6 hours after injury. Subsequently, a skin-stretching device combined with vacuum sealing drainage was applied to reduce the skin defect. This treatment proved to be valuable for the closure of the skin defect and to attain successful functional rehabilitation without sciatic nerve entrapment or amputation in this case.
It is difficult to close large skin defects, especially when they are infected. The application of a skin-stretching device combined with vacuum sealing drainage should be commonly applied to treat infected wounds because it is a safe and easy operative technique.
本病例报告介绍了通过皮肤拉伸装置结合封闭负压引流治疗因意外爆炸导致的大面积感染性皮肤缺损。据我们所知,我们所治疗的伤口面积目前可能是最大的。
一名41岁的亚洲男性因100枚雷管意外爆炸导致右下肢开放性感染伤口伴大面积皮肤缺损,被转至我院创伤外科中心进行伤口闭合治疗。其右臀伤口约40 cm×35 cm。入院时,伤口有出血,外观发黑,并有散在金属异物。受伤6小时后对其右臀区域进行了清创。随后,应用皮肤拉伸装置结合封闭负压引流以缩小皮肤缺损。在本病例中,该治疗方法对于闭合皮肤缺损以及实现成功的功能康复且无坐骨神经受压或截肢情况被证明是有价值的。
闭合大面积皮肤缺损很困难,尤其是当它们被感染时。皮肤拉伸装置结合封闭负压引流的应用应普遍用于治疗感染伤口,因为它是一种安全且操作简便的手术技术。