Treatment of soft tissue wounds using free autodermoplasty
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16422Keywords:
explosive trauma, wound, free autodermoplasty, vacuum dressingAbstract
The aim of the work: to assess of the results of treatment of patients with soft tissue wounds by using free autodermoplasty.
Materials and Мethods. We analyzed the results of surgical treatment of 52 patients with soft tissue wounds. The causes were: gunshot shrapnel wounds of soft tissues in 39 (75.0 %) cases, gunshot shrapnel blind wounds of soft tissues combined with gunshot fractures of the limbs – in 10 (19.2 %), deep thermal burns – in 3 (5.8 %). The patients were assigned to two groups: Group I (n=28) consisting of patients to which autodermoplasty was performed in a conventional method, Group II (n=24) consisting of patients, which received the VAC-system after autodermoplasty. All the injured were men. The average age was (36.8±2.5) years.
Results. The autodermoplasty was performed with epidermal flaps in 3 (5.8 %) cases, a split flap was used in 40 (76.9 %) cases, and a layered skin flap was used in 9 (17.3 %) cases. Complications after autodermoplasty in Group I patients were observed in 4 (7.7 %) cases: wound seroma – 2 (3.8 %), purulent wound – 1 (1.9 %), complete necrosis of the flap – 1 (1.9 %). In Group II patients, one case was observed (1.9 %) as a partial necrosis of the autodermograft. The average duration of hospital stay in Group I patients was (19.8±2.5) days and in Group II patients was (12.4±2.3) days.
Conclusions. The use of a vacuum dressing after free autodermoplasty allows to reduce the duration of the patients stay in the hospital by 7.4 days and reduce the frequency of postoperative complications by 5.8 % (p <0.05). Careful preparation of the wounds also plays an important role in the success of free autodermoplasty. Free autodermoplasty with epidermal flaps is advisable to use for burn wounds, split flaps – in patients with gunshot wounds of the limbs that are not subject to constant pressure, layered flaps – in the presence of wounds on the supporting surfaces of the limbs.
References
Zarutskii YL, Aslanyan SA, Plis IB, Kompaniiets AO, Goncharuk VS. Aplication of NPWT in the surgical treatment of wounds and injuries of various locations – case series. Negative pressure wound therapy journal. 2018; 5(3):10-13. DOI: 10.18487/npwtj.v5i3.44. DOI: https://doi.org/10.18487/npwtj.v5i3.44
Khomenko IP, Korol SO, Khalik SV, Shapovalov VY, Yenin RV, Herasymenko OS, et al. Klinichno-epidemiolohichnyi analiz struktury boiovoi khirurhichnoi travmy pry provedenni antyterorystychnoi operatsii / operatsii Obiednanykh syl na skhodi Ukrainy [Clinical and epidemiological analysis of the structure of combat surgical trauma during the anti-terrorist operation / operation of the Joint Forces in eastern Ukraine]. Ukrainian Journal of Military Medicine. 2021; 2(2):5-13. DOI: 10.46847/ujmm.2021.2(2)-005. Ukrainian. DOI: https://doi.org/10.46847/ujmm.2021.2(2)-005
Denysiuk MV, Dubrov SO, Cherniaiev SV, Sereda SO, Zaikin YM. Struktura travmatychnykh ushkodzhen ta dosvid likuvannia poranenykh vnaslidok boiovykh dii v pershi dni napadu rosii na Ukrainu [Structure of traumatic injuries and experience in treating the wounded as a result of hostilities in the first days of Russia's attack on Ukraine]. Pain, Anaesthesia & Intensive Care. 2022; 1(98): 7-12. DOI: 10.25284/2519-2078.1(98).2022.256092. Ukrainian. DOI: https://doi.org/10.25284/2519-2078.1(98).2022.256092
Lurin IA, Khomenko IP, Nehoduiko VV, Tertyshnyi SV. Kombinatsiia multymodalnoho alhorytmu ta rekonstruktyvno-vidnovliuvalnoi drabyny pry likuvanni poranenykh iz vohnepalnymy defektamy miakykh tkanyny [Combination of multimodal algorithm and reconstructive-restorative ladder in the treatment of wounded with gunshot defects of soft tissues]. Kharkiv Surgical School. 2022; 3(114): 57-60. DOI: 10.37699/2308-7005.3.2022.10. Ukrainian. DOI: https://doi.org/10.37699/2308-7005.3.2022.10
Vitse J, Bekara F, Bertheuil N, Sinna R, Chaput B, Herlin C. Perforator-based propeller flaps reliability in upper extremity soft tissue reconstruction: a systematic review. J Hand Surg Eur. 2017; 42(2):157-64. DOI: 10.1177/1753193416669262. DOI: https://doi.org/10.1177/1753193416669262
Zavhorodnii SM, Bulba PO. Likuvannia izolovanykh vohnepalnykh ulamkovykh poranen miakykh tkanyn iz vykorystanniam autodermoplastyky [Treatment of isolated gunshot shrapnel wounds of soft tissues using autodermoplasty]. Hospital Surgeon. 2025; 4: 55-60. DOI: 10.11603/2414-4533.2025.4.15619. Ukrainian. DOI: https://doi.org/10.11603/2414-4533.2025.4.15619
Rybalka YV. Zastosuvannia PRP-terapii v kompleksi peredoperatsiinoi pidhotovky do autodermoplastyky pry likuvanni khronichnykh ran [The use of PRP therapy in the complex of preoperative preparation for autodermoplasty in the treatment of chronic wounds]. Actual Problems of Modern Medicine. 2018; 18(1):117-20. Ukrainian.
Napolitano R. Negative pressure wound therapy with instillation in lower extremity wounds may contribute to cost-savings: 4 case reports. Wound Manag Prev. 2023; 69(2):32-8. DOI: https://doi.org/10.25270/wmp.2023.2.22058
Zarutskіi YL, Plis IB, Korol SO, Kompaniiets AO. Optymizatsiia etapnoho khirurhichnoho likuvannia poranenykh na osnovi metrychnoi klasyfikatsii defektiv miakykh tkanyn [Optimization of staged surgical treatment of the wounded based on the metric classification of soft tissue defects]. Klinichna khirurhiia. 2018; 85(2):77-80. DOI: 10.26779/2522-1396.2018.02.77. Ukrainian. DOI: https://doi.org/10.26779/2522-1396.2018.02.77
Andasbekov N, Omarov N, Imangazinov S, Kairkhanov Y, Tashtemirova O, Kazangapov R, et al. Application of improved autodermoplasty technique in granulating wounds treatment. Georgian Med News. 2024; (356):171-75.
Tsymbaliuk VI. Atlas boiovoi khirurhichnoi travmy (dosvid antyterorystychnoi operatsii / operatsii Оbiednanykh syl): monohrafiia [Atlas of combat surgical trauma (experience of anti-terrorist operation / operation of the Joint Forces): monograph]. Kharkiv: Kolehium. 2021; 385. Ukrainian.
Yasir M, Wani AH, Zargar HR. Perforator flaps for reconstruction of lower limb defects. World J Plast Surg. 2017; 6(1):74-81.
Battiston B, Ciclamini D, Tang JB. Compound or specially designed flaps in the lower extremities. Clin Plast Surg. 2017; 44(2):287-97. DOI: 10.1016/j.cps.2016.11.006. DOI: https://doi.org/10.1016/j.cps.2016.11.006
Franco MJ, Nicoson MC, Parikh RP, Tung TH. Lower extremity reconstruction with free gracilis flaps. J Reconstr Microsurg. 2017; 33(3):218-24. DOI: 10.1055/s-0036-1597568. DOI: https://doi.org/10.1055/s-0036-1597568
Wong JK, Deek N, Hsu CC, Chen HY, Lin CH. Versatility and "flap efficiency" of pedicled perforator flaps in lower extremity reconstruction. J Plast Reconstr Aesthet Surg. 2017; 70(1):67-77. DOI: 10.1016/j.bjps.2016.09.028. DOI: https://doi.org/10.1016/j.bjps.2016.09.028
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