Vacuum Sealing Drainage Treatment Combined with Antibiotic-Impregnated Bone Cement for Treatment of Soft Tissue Defects and Infection.
BACKGROUND This study aimed to evaluate the combined effect of vacuum sealing drainage (VSD) and antibiotic-loaded bone cement on soft tissue defects and infection. MATERIAL AND METHODS This prospective non-blinded study recruited 46 patients with soft tissue defects and infection from January 2010 to May 2014 and randomly divided them into experimental and control groups (n=23). Patients in the experimental group were treated with VSD and antibiotic-loaded bone cement, while the patients in the control group were treated with VSD only. RESULTS In the experimental group, the wound was healed in 23 cases at 4 weeks postoperatively, of which direct suture was performed in 12 cases, and additional free flap transplantation or skin grafting was performed in 6 cases and 5 cases, respectively. No infection reoccurred in 1-year follow-up. In the control group, the wound was healed in 15 cases at 6 weeks postoperatively, of which direct suture was performed in 8 cases, and additional free flap transplantation or skin grafting was performed in 3 cases and 4 cases, respectively. In the other 8 cases the wound was healed at 8 weeks postoperatively. Infection reoccurred in 3 cases during the follow-up. The experimental group had significantly fewer VSD dressing renewals, shorter time needed until the wound was ready for surgery, shorter duration of antibiotic administration, faster wound healing, and shorter hospital stay than the control group (p<0.01). CONCLUSIONS The combination of VSD and antibiotic bone cement might be a better method for treatment of soft tissue defects and infection.
7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland).
Xin
X
Liu
Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland).
Jiulong
J
Liang
7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland).
Jun
J
Zao
Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland).
Liangliang
L
Quan
7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland).
Xunyuan
X
Jia
7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland).
Mingchao
M
Li
Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland).
Kai
K
Tao
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001843:Bone Cements; D004322:Drainage / Q000379:methods*; D004359:Drug Therapy, Combination; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000601:surgery; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D016038:Skin Transplantation / Q000379:methods; D017695:Soft Tissue Injuries / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery / Q000628:therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D014618:Vacuum; D014945:Wound Healing
D000900:Anti-Bacterial Agents; D001843:Bone Cements