To analyze the clinical effect of preoperative vacuum sealing drainage combined with local rotary flap to repair sacrococcygeal pressure injury.

From June 2014 to December 2017, 48 patients with pressure injury admitted to Department of Burns and Plastic Surgery, First Affiliated Hospital of Soochow University were selected, including 32 males and 16 females. The patients were divided into observation group (n=24) and control group (n=24) according to random number table method. After admission, the patients of control group were given bedside debridement and daily dressing change, while the patients of observation group were given bedside debridement and vacuum sealing drainage treatment. After 5 to 7 days of admission treatment, both groups were treated with local rotation flap and vacuum sealing drainage treatment and drainage to repair the sacrococcygeal pressure injury, while sleeping in a floating bed. One week after local rotation flap, vacuum sealing drainage was removed and wound dressing was changed until healing. The grade A and grade B healing rate, flap necrosis rate, wound dehiscence rate 2 weeks after operation and healingtime, hospital stay were compared between the two groups. Data were processed with t test and Fisher exact probability test .

Two weeks after surgery, 8 patients were healed in grade A, 12 patients in grade B, and 4 patients in grade C in the observation group. Three patients were healed in grade A, 11 patients in grade B, and 10 patients in grade C in the control group. The healing rate of grade A and grade B in the observation group was 83.33% (20/24), compared with that in the control group [58.33% (14/24)], there was not statistically significant (P=0.080). Two weeks after surgery, 2 patients had partial necrosis of the distal vein of the flap after blood congestion, and there were 7 patients of their wounds dehiscence when stitches were removed in the observation group. Two weeks after surgery, in the control group, there was partial necrosis of skin flap in 9 patients, while wounds dehiscence in 14 patients when the suture was removed. All of them were healed after dressing change. The rate of postoperative flap necrosis [8.33%(2/24)] and postoperative wound debridement [29.17%(7/24)] in the observation group were superior to those in the control group [37.50%(9/24), 58.33%(14/24)], the differences were statistically significant (P=0.036, 0.005). The length of hospital stay [(21.5±3.0) d] and healing time [(32.2±3.1) d] in the observation group were significantly shorter than those in the control group[(24.3±2.4) d] and [(35.7±3.3) d], the differences were statistically significant (t=3.565, 3.719; with P values below 0.01). All 48 patients were followed up for 2-6 months after the operation. All the flaps survived well and no recurrence of pressure injury occurred.

The application of preoperative vacuum sealing drainage combined with local rotary flap in the repair of sacrococcygeal pressure injury can significantly improve the clinical efficacy of patients, reduce the length of hospital stay, healing time and postoperative complications.