To investigate the clinical application of vacuum sealing drainage (VSD) in chronic
osteomyelitis of the extremities combined with soft tissue defects in adults. This study retrospectively included 32 adult patients with clearly diagnosed chronic
osteomyelitis of the extremities combined with local soft tissue defects, and the
trauma was covered by VSD after
debridement,
osteotomy, and
vancomycin-laden
bone cement filling of the occupancy, and the
trauma was covered by selecting a suitable flap transfer repair according to the site and extent of the soft tissue defect after the
trauma condition was suitable, and the
secondary trauma was taken from the abdominal full-thickness skin free skin slice graft, according to whether the skin graft area was performed. The skin flap
hematoma and
infection rate, as well as the skin flap survival rate and implant fixation time were compared and analysed between the two groups. The primary outcome is the implant fixation time, and the secondary outcome is the skin fragment survival rate. In 32 patients, VSD was performed on the
bone cement surface to cover the
trauma, and 33.2 to 39.8 kPa continuous vacuum sealing drainage was set. The average VSD time duration before soft tissue coverage was 47.87 ± 23.14 days, and the average number of VSD use was 7.18 ± 3.23. The use of VSD before soft tissue coverage did not cause complications such as negative pressure could not be maintained, vacuum sealing drainage was not smooth, skin blistering,
trauma. Among the 32 patients, 12 cases of soft tissue coverage were followed by
trauma free
skin grafting with packing + VSD, and 20 cases were fixed with packing alone, and the duration of continuous packing and fixation of free skin pieces in the VSD group was significantly less than that in the control group (P = .006). The survival rate was significantly higher than that of the control group (P = .019). VSD in adult patients with chronic
osteomyelitis of the extremities combined with soft tissue defects can effectively improve the
trauma condition, provide the possibility of second-stage soft tissue coverage, and significantly shorten the preparation time for soft tissue coverage. In addition, when soft tissue coverage
trauma is performed, VSD combined with skin graft packing technique can significantly improve the survival rate of skin pieces, shorten the time of skin graft fixation.