To compare the effects of applying packing compression, vacuum sealing drainage (VSD) technology and micro-dynamic negative pressure therapy (MDNPWT) in skin grafting on children′s limbs and trunk wounds, and analyze the clinical efficacy of MDNPWT in children′s wound skin grafting.

The prospective randomized controlled study were used, from August 2019 to May 2021, Kunming Children′s Hospital admitted a total of 90 children who met the enrollment criteria and completed the study. The children were divided into MDNPWT group and VSD group according to the random number table method. And packaging group. After admission, the three groups of children underwent routine preoperative wound treatment. During the operation, the wound was debrided and then a large medium thick leather was used to repair the wound. The MDNPWT group used microdynamic negative pressure wound dressing to fix the skin graft, and the other two groups used VSD and traditional packaging methods to fix the skin graft. piece. The dressings were removed 7 days after the operation of the children in the 3 groups, and the dressing was changed routinely until the wounds healed completely. Observed and recorded the operation time, wound healing rate, number of postoperative dressing changes, surgical and postoperative treatment costs, pain (FLACC score) and postoperative adverse reactions in the three groups. The measurement data were compared by one-way analysis of variance test, SNK-q test and repeated measures analysis of variance, the count data were compared by χ² test.

The operation time of MDNPWT group, packing group and VSD group: (46.1±10.5) , (77.0±11.6) , (53.9±19.6) min, respectively, the difference between the groups was statistically significant (F=85.54, P<0.01 ); The MDNPWT group was compared with the packaged group, the difference was statistically significant(q=17.51, P<0.01), and compared with the VSD group, the difference was statistically significant(q=3.79, P<0.01). The wound healing rates of MDNPWT, packaged group and VSD group were (96.3±3.2)%, (77.2±10.9)%, (91.8±7.3)%, respectively, and the difference between the groups was statistically significant (F=47.85, P<0.01) ; Comparing MDNPWT group with packaged group, the difference was statistically significant(q=13.11, P<0.01), comparing MDNPWT group with VSD group, the difference was not statistically significant (q=3.79, P>0.05). The number of postoperative dressing changes in the MDNPWT group, the packaged group and the VSD group were (2.4±1.2), (8.4±2.8), (2.5±1.7) times, respectively, and the difference between the groups was statistically significant (F=82.36, P<0.01); the MDNPWT group was compared with the packaged group, the difference was statistically significant (q=15.66, P<0.01), compared with the VSD group, the difference was not statistically significant (q=0.25, P>0.05). The surgical and postoperative treatment costs of the MDNPWT group, the packing group and the VSD group were (5253.7±652.3), (7545.6±736.8)and (6543.3±481.4) yuan, respectively. There was a statistically significant difference between the groups (F=96.53, P<0.01); the MDNPWT group was compared with the packaged group, the difference was statistically significant (q=19.64, P<0.01), and compared with the VSD group, the differences were statistically significant(q=10.47, P<0.05). FLACC score: 1 h after operation, MDNPWT group, packaged group and VSD group were respectively (3.7±1.2), (5.6±1.7), (5.5±1.5) points, and the difference between the groups was statistically significant (F=15.35, P<0.01); MDNPWT group compared with packaged group, the difference was statistically significant (q=7.03, P<0.01), compared with VSD group, the difference was statistically significant (q=6.36, P<0.05). 48 hours after the operation, the scores of the MDNPWT group, the packing group and the VSD group were (2.1±0.7), (2.7±0.9)and (3.2±0.6) points, respectively. The difference between the groups was statistically significant (F=13.46, P< 0.01); the MDNPWT group was compared with the packaged group, the difference was statistically significant (q=3.71, P<0.05), and compared with the VSD group, the differences were statistically significant (q=7.34, P<0.01). After the first dressing change after operation, the scores of MDNPWT group, packaged group and VSD group were (3.1±1.3), (4.8±1.4), and (4.3±1.5) points, respectively. The difference between the groups was statistically significant (F=10.61, P <0.01); the MDNPWT group was compared with the packaged group, the difference was statistically significant(q=6.37, P<0.01), and compared with the VSD group, the differences were statistically significant (q=4.43, P<0.01). Adverse reactions after surgery: The incidence of infection was 3.4%, 5.9%, and 3.7% in the MDNPWT group, packaged group and VSD group, respectively. There was no statistically significant difference between the groups (χ²=0.63, P>0.05). The incidence of eczema was 3.4%, 5.9%, and 25.9% in the MDNPWT group and the packaged group and the VSD group, respectively. The difference between the groups was statistically significant (χ²=6.06, P<0.05); the MDNPWT group was compared with the packaged group, the difference was not statistically significant (χ²=0.20, P>0.05), compared with the VSD group, the difference was statistically significant(χ²=5.77, P<0.05). The incidence of tension blisters was 0, 5.9%, and 18.5% in the MDNPWT group, the packing group and the VSD group, respectively. The difference between the groups was statistically significant (χ²=8.67, P<0.05); the MDNPWT group was compared with the packing group, the difference was statistically significant (χ²= 1.76, P<0.05), compared with the VSD group, the difference was statistically significant (χ²=5.90, P<0.05).

In the treatment of children′s limbs and trunk wounds with skin grafts, the application of microdynamic negative pressure technology to fix the skin grafts can effectively shorten the operation time, improve wound healing rate, reduce the number of postoperative dressing changes and pain, reduce treatment costs, and reduce postoperative adverse reactions, Safe and effective.