Use of prolonged closed suction drainage for synovial fluid-draining wounds around the ankle.

IF 1.5 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-03-01 DOI:10.12968/jowc.2022.0029

Park Hyun-Jin, You Ki-Han, Hong Seokho, Kim Hyong Nyun

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引用次数: 0

Abstract

Objective: When synovial fluid drains through a wound, cells necessary to form tissue required for healing are washed away. This results in failure of wound closure, often necessitating a pedicled or free flap reconstruction. We hypothesised that prolonged (>48 hours post surgery) closed suction drainage can reduce the fluid draining through the wound, enabling wound healing and eliminating the need for a pedicled or free flap reconstruction. We also aimed to determine whether prolonged application of closed suction drainage would increase postoperative infection.

Method: A retrospective study was performed between August 2015 and December 2020. Patients with fluid-draining wounds around the ankle which had failed to respond to treatment with delayed closure and which required the use of prolonged closed suction drainage were included. Closed suction (Jackson-Pratt, JP) drainage was applied from the time of wound closure until the wound healed.

Results: A total of 20 patients (12 male: eight female; mean age: 52 years; range: 21-74 years) were included in the study. The results showed the JP drain being kept for a mean of 14.1±1.8 (range: 9-16) postoperative days. Prolonged closed suction drainage helped achieve wound closure in 19 (95%) patients. Only one patient with Achilles tendon exposure underwent sural flap surgery. None of the patients developed an infection due to prolonged use of the JP drain. With regards to patient satisfaction, four (21%), 10 (53%), four (21%) and one (5%) patients were 'very satisfied', 'satisfied', 'fair' and 'dissatisfied', respectively, with the results of the treatment technique at follow-up (mean: 29.9; range: 12-72 months). The remaining patient was lost to follow-up.

Conclusion: Prolonged application of closed suction drainage made wound closure possible for synovial fluid-draining wounds, eliminating the need for a pedicled or free flap surgery, without increasing the rates of wound infection. This technique could be used as an adjunct to the local flap, negative pressure wound therapy or other reconstructive techniques at the time of revision surgery.

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长时间闭式抽吸引流治疗踝关节周围滑膜液引流伤。

目的：当滑液流经伤口时，形成愈合所需组织所需的细胞被冲走。这导致伤口关闭失败，通常需要带蒂或自由皮瓣重建。我们假设延长（术后48小时）封闭吸引引流可以减少伤口的液体排出，促进伤口愈合并消除对带蒂或自由皮瓣重建的需要。我们还旨在确定长期应用闭合吸引引流是否会增加术后感染。方法：2015年8月至2020年12月进行回顾性研究。踝关节周围有排液伤口的患者，延迟闭合治疗无效，需要使用长时间的闭合吸引引流。自创面闭合时起至创面愈合时，应用闭合吸引（Jackson-Pratt， JP）引流。结果：共20例患者，其中男性12例，女性8例；平均年龄：52岁；研究范围：21-74岁)。结果显示JP引流液术后平均保留14.1±1.8（范围：9-16）天。19例（95%）患者采用长时间的闭式吸引引流术实现伤口闭合。只有1例跟腱外露患者行腓肠皮瓣手术。所有患者均未因长期使用JP引流管而发生感染。在患者满意度方面，随访时对治疗技术的满意度分别为“非常满意”4例（21%）、“满意”10例（53%）、“一般”4例（21%）和“不满意”1例（5%）(平均：29.9；范围：12-72个月)。其余患者未随访。结论：长期应用闭合吸引引流使滑膜液引流创面闭合成为可能，无需带蒂或游离皮瓣手术，且不增加创面感染率。在翻修手术时，该技术可作为局部皮瓣、负压伤口治疗或其他重建技术的辅助手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.