Experience of VSD Application in Treatment of Gustilo Ⅲ type Soft Tissue Injury with Staging Treatment Strategies

Abstract：Objective To investigate staging treatment strategies using VSD in treatment of Gustilo typeⅢsoft tissue in-jury. Methods In our university,from August 2009 to August 2012,24 patients with the Gustilo type Ⅲ soft tissue injury of limb were treated by staging treatment strategies. Emergency stage included early debridement,blood vessels,nerves and ten-dons repairment,external fixation of the fractures,using VSD to cover the wound. After 24~72 hours,second stage included re-peat debridement,using VSD to cover the wound,till non-infected necrotic tissue were found and the growth of granulation tis-sue is well. Third stage included free skin graft or flap repair of the wound. Results nfections of the 24 patients were well con-trolled,bacterial cultures were negative,the free skin graft or flap reconstruction successful covers the wound. 21 patients had 9~36 months follow-up. A forearm injury patient inderwent tendon release surgery 10 months later. Three patients of ankle inju-ry underwent ankle arthrodesis 6 months later,all wounds healed well. Conclusion Gustilo type Ⅲ injury of the limb should be treated in stages. After emergency debridement,VSD palys an important role in covering the wound. It helps the infected necrotic tissue discharged,to control the wound infection,to increase the growth of granulation. VSD can create good microenvi-ronment for later wound reconstruction.