title: [Application of vacuum sealing drainage in severe skin closed internal degloving injury].
abstract: OBJECTIVE
  To investigate the effectiveness of the vacuum sealing drainage (VSD) technique with split middle thickness skin replantation for the treatment of severe skin closed internal degloving injury (CIDI).
  
  
  METHODS
  Between July 2008 and April 2011, 16 patients with severe skin CIDI were treated. There were 11 males and 5 females, aged 17-56 years (mean, 28 years). Injury was caused by traffic accident in all cases. The time between injury and operation was 2-8 hours (mean, 5 hours). Peeling skin parts included the upper limb in 3 cases and the lower limb in 13 cases. The range of skin exfoliation was 5%-12% (mean, 7%) of the body surface area with different degree of skin contamination. After thorough debridement, exfoliative skin was made split middle thickness skin graft for in situ replantation, and then VSD was performed.
  
  
  RESULTS
  After 7 days of VSD therapy, graft skin survived successfully in 14 cases; partial necrosis of graft skin occurred in 2 cases, and was cured after thorough debridement combined with antibiotics for 7 days. All patients were followed up 6-18 months (mean, 12 months). The appearance of the limb was satisfactory without obvious scar formation, and the blood supply and sensation were normal. The joint function was normal.
  
  
  CONCLUSIONS
  For patients with severe skin CIDI, VSD treatment combined with split middle thickness skin replantation can improve the local blood circulation of the limb, promote replantation skin survival, and shorten healing time of wound. The clinical effectiveness is satisfactory.
authors.affiliation: Department of Orthopedics, the 2nd Hospital Affiliated to Henan College of Traditional Chinese Medicine, Zhengzhou Henan, 450002, P R China. zhaoyangniu@126.com
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Niu
authors.forename: Youzhang
authors.initials: Y
authors.lastname: Deng
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Sun
authors.forename: Shangzeng
authors.initials: S
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000293:injuries*; D016038:Skin Transplantation; D013524:Surgical Flaps; D014618:Vacuum; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult