To observe the effect of medical collagen sponge and vacuum sealing drainage (VSD) combined with autologous epidermal skin graft in the treament of refractory wound of foot destructive injury.

From January 2017 to October 2019, 18 patients with refractory wounds after foot destructive injury were treated in Department of Burns and Wound Repair Surgery, Hainan Provincial People′s Hospital, including 12 cases with dorsal tendon of foot exposure, 6 cases with metatarsal bone exposure. After debridement, collagen sponge was given to cover the tendon exposed and bone exposed wound, and VSD device was installed. When granulation tissue cover the wound, the autologous epidermal skin was grafted on. The duration of treatment, the rate of necrosis of exposed tendon or bone and the survival rate of epidermal skin were recorded. All patients were followed up for 6 months. The appearance and function of patients were evaluated after the treatment.

The feet of 18 patients were preserved. The exposed tendons and bones remained activity. Survival rate of epidermal skin was 85%-95%, average(90±5)%. All residual wounds healed after intermittent dressing change. The duration of treatment were 14.0-45.0 d, average(29.5±15.5) d. The foot function was assessed by Maryland foot function score in 6th month after discharge, excellent in 3 cases, good in 4 cases, moderate in 6 cases and poor in 5 cases.

Medical collagen sponge and VSD can promote the growth of granulation tissue in the wound with exposed tendon or bone, and meanwhile retentive their activity, which can repair the refractory wound of foot destructive injury combined with autologous epidermal skin graft.