Application effect of vacuum sealing drainage combined with nano-silver dressings in the treatment of non-healing wounds after surgery for open limb fractures.

Abstract

Background: Non-healing wounds after open limb fracture surgery pose clinical challenges, requiring effective management; vacuum sealing drainage (VSD) promotes healing by removing exudate and stimulating granulation, while nano-silver dressings provide antimicrobial protection to reduce infection risk. We aimed to probe the application effect of VSD combined with nano-silver dressings in the treatment of non-healing wounds after surgery for Gustilo type III open limb fractures.

Methods: A total of 60 patients with non-healing wounds after surgery for Gustilo type III open limb fractures were randomly divided into two groups, with 30 cases in each group. The control group received conventional therapy, and the study group received VSD combined with nano-silver dressings. Before treatment and after 7 days of treatment, inflammatory cytokines (C-reactive protein (CRP) and procalcitonin (PCT)) in serum and growth factors (transforming growth factor beta1 (TGF-β1) and vascular endothelial growth factor (VEGF)) in wound exudate were measured using enzyme-linked immunosorbent assay. The pain level of the patients was measured by the Visual Analogue Scale (VAS). Patients' skin quality was assessed by the Vancouver Scar Scale (VSS), and the efficacy of trauma treatment was observed in both groups.

Results: After 7-day treatment, the study group performed lower levels of CRP and PCT, higher levels of TGF-β1 and VEGF, lower VAS scores and VSS scores, and better overall treatment rate compared to the control group (all P < 0.05).

Conclusion: VSD combined with nano-silver dressings has good therapeutic efficacy in non-healing wounds after surgery for open limb fractures and can inhibit inflammatory response and improve skin quality.