Diabetic foot ulcers (DFUs) are common chronic wounds and a common complication of diabetes. The foot is the main site of diabetic ulcers, which involve small and medium-sized arteries, peripheral nerves, and microcirculation, among others. DFUs are prone to coinfections and affect many diabetic patients. In recent years, interdisciplinary research combining medicine and material science has been increasing and has achieved significant clinical therapeutic effects, and the application of vacuum sealing drainage (VSD) in the treatment of DFUs is a typical representative of this progress, but the mechanism of action remains unclear. In this review, we integrated bioinformatics and literature and found that ferroptosis is an important signaling pathway through which VSD promotes the healing of DFUs and that System Xc-GSH-GPX4 and NAD(P)H-CoQ10-FSP1 are important axes in this signaling pathway, and we speculate that VSD is most likely to inhibit ferroptosis to promote DFU healing through the above axes. In addition, we found that some classical pathways, such as the TNF, NF-κB, and Wnt/β-catenin pathways, are also involved in the VSD-mediated promotion of DFU healing. We also compiled and reviewed the progress from clinical studies on VSD, and this information provides a reference for the study of VSD in the treatment of DFUs.

UNASSIGNED: The authors have no conflicts of interest.

OBJECTIVE: To study the effects of skin flap grafting combined with vacuum sealing drainage (VSD) on ulcer area, pain level and serum inflammation in patients with diabetic foot (DF).
METHODS: In this retrospective study, 121 patients with DF who were treated in the Affiliated Hospital of Xinyang Vocational and Technical College between April 2018 and April 2022 were included as study subjects, including 50 cases receiving skin flap grafting (control group) and 71 cases receiving skin flap grafting combined with VSD (research group). Information on clinical efficacy, survival rate of the grafted flap, amputation and complications, ulcer area, rehabilitation (granulation tissue formation time, ulcer wound healing time), pain level (Visual Analogue Scale [VAS]), and serum inflammatory factors (interleukin [IL]-6, tumor necrosis factor [TNF]-α, and C-reactive protein [CRP]) were collected for comparative analyses. Univariate and multivariate analyses were conducted to screen the risk factors for patients\' prognosis.
RESULTS: The overall response rate and the survival rate of the grafted flap in the research group were markedly higher compared with the control group, while the amputation rate was significantly lower (all P<0.05). Besides, the research group exhibited an evidently smaller post-treatment ulcer area, lower VAS, IL-6, TNF-α and CRP levels, and shorter granulation tissue formation time and ulcer wound healing time than the control group (all P<0.05). Neither group of patients experienced significant complications. The use of skin flap grafting + VSD was a protective factor for postoperative outcome.
CONCLUSIONS: Skin flap grafting combined with VSD is effective in treating DF patients, which can validly reduce ulcer area and inhibit serum inflammation after treatment, thus accelerating rehabilitation.

OBJECTIVE: This study aimed to assess the clinical efficacy of combining vacuum sealing drainage with full irrigation in managing oral and maxillofacial space infections and its impact on serum inflammatory factor levels in patients.
METHODS: We retrospectively analyzed data from 110 patients with oral and maxillofacial space infections treated at our hospital between February 2018 and March 2022. Among them, 50 patients underwent simple negative pressure closed drainage (control group), while 60 patients received combined full irrigation using 0.9% sodium chloride solution (observation group). We compared clinical treatment outcomes, treatment duration, antibiotic usage duration, quality of life scores, Visual Analogue Scale (VAS) scores, changes in serum IL-6 and TNF-α levels before and after treatment, and the incidence of complications between the two groups. Additionally, we conducted an analysis of risk factors influencing patient prognosis.
RESULTS: The observation group exhibited significantly superior treatment efficacy compared to the control group (P < 0.05). Treatment and antibiotic usage durations were shorter in the observation group (P < 0.05). VAS scores after treatment were significantly lower in the observation group (P < 0.05). Serum inflammatory factors improved significantly in both groups after treatment, with a more substantial improvement observed in the observation group (P < 0.05). Post-treatment quality of life was significantly higher, and the incidence of complications was lower in the observation group (P < 0.05). The choice of treatment method independently influenced patient prognosis (P < 0.05).
CONCLUSIONS: Combining vacuum sealing drainage with full irrigation is an effective approach for managing oral and maxillofacial space infections. This treatment leads to improved clinical symptoms, reduced inflammatory responses, decreased pain intensity, and enhanced quality of life while maintaining safety.

BACKGROUND: The prevalence of diabetic foot ulcers, a common, more serious chronic diabetes-related complication, is increasing. Vacuum sealing drainage (VSD) constitutes an effective adjunctive treatment for diabetic foot ulcers. Factors, such as poor glycemic control, ischemia, and infection prolong wound healing time, and VSD products are expensive and unaffordable for many patients.
OBJECTIVE: To compare the use of customized VSD and customized VSD in the treatment of diabetic foot ulcer.
METHODS: This retrospective study included 83 patients with diabetic foot ulcers in customized VSD (n = 44) and VSD (n = 39) groups. Baseline data, efficacy after 14 days, total treatment efficiency, final outcome (28 days after treatment, healing rate), average treatment cost, and hospitalization (days) of the two groups were compared. Factors affecting wound healing were analyzed.
RESULTS: No significant intergroup differences in the baseline data were detected (VSD vs. customized VAD, p > 0.05). Treatment efficacy was higher in the customized VSD group than in the VSD group after 14 days (p < 0.05), although total treatment efficiency in both groups reached 100%. The final outcome in the customized VSD group was better (vs. VSD group, p < 0.05), and the wound healing rate was higher than in the VSD group (66.7% vs. 33.3%). The mean treatment cost and hospital days were greater in the VSD group (vs. customized VSD group; p < 0.05). Factors affecting wound healing include age, Wagner classification, HDL-C, and fasting C-peptide. Younger age, low Wagner classification grade, low HDL-C level, and high fasting C-peptide contribute to higher healing rate, CONCLUSION: Efficacy and final outcome of customized VSD were better than that of VSD; the customized VSD device is simple and convenient to operate, and enables cost-effective treatment.

BACKGROUND: To compare the clinical efficacy of vacuum sealing drainage, eggshell-like debridement combined with antibiotic calcium sulphate implantation and conventional debridement combined with antibiotic calcium sulphate implantation in the treatment of calcaneal osteomyelitis.
METHODS: Sixty-six patients with calcaneal osteomyelitis who were treated in our department between January 2017 and August 2021 were included in this study. Thirty-one patients underwent VSD and eggshell-like debridement combined with antibiotic calcium sulphate implantation. Thirty-five patients underwent conventional debridement combined with antibiotic calcium sulphate implantation. The inflammatory markers, operation time, wound healing time, hospital stay, full weight bearing time after operation, recurrence rate of infection, complications, and American Orthopedic Foot and Ankle Society (AOFAS) scores were compared between the two groups.
RESULTS: The operation time and full weight bearing time after operation of observation group were longer than that of control group. Compared with preoperative results, WBC, ESR, CRP and PCT in both groups were significantly decreased at 14 days after operation, and there was no statistical significance between the two groups. The wound healing time and hospital stay in the observation group were shorter than those in the control group (P < 0.05). There were four patients with aseptic exudation in the observation group and ten patients with aseptic exudation in the control group, and the wounds healed well after multiple dressing changes. Seven patients in the observation group underwent secondary bone grafting due to bone defects, and four patients in the control group received secondary bone grafting due to bone defects. In the observation group, three patients received debridement combined with antibiotic calcium sulphate implantation again due to recurrent infection, compared with seven patients in the control group. One year after operation, the observation group had a better AOFAS scores than the control group, especially in terms of foot function (P < 0.05).
CONCLUSIONS: Compared with conventional debridement and antibiotic calcium sulphate implantation, VSD and eggshell-like debridement combined with antibiotic calcium sulphate implantation in the treatment of calcaneal osteomyelitis can shorten the wound healing and hospital stay of patients, reduce postoperative aseptic exudation complications and infection recurrence rate, and better preserve the foot function, which is a simple and effective method.

OBJECTIVE: Acute compartment syndrome (ACS) is an urgent, critical condition that requires immediate fasciotomy once diagnosed. Traditionally, fasciotomy of the forearms and lower leg involves one or two long approaches. Our previous study demonstrated that mini approaches fasciotomy was an effective method to treat ACS. This study is aimed at further evaluating the limb functions and complications of mini approaches combined with vacuum sealing drainage (VSD) for treating ACS caused by fractures in the forearms and lower legs.
METHODS: This was a retrospective cross-sectional study, and after applying the inclusion and exclusion criteria, we reviewed 126 children who underwent mini treatment approaches for ACS from Jan 2008 to Jan 2022. The selected patients were divided into two groups: group A (ACS group; 58 patients aged 7.77±3.45 years) and group B (ACS combined with VSD; 68 patients aged 7.17±3.55 years). Patients\' clinical data were collected. The patients were followed up, and muscle function in the forearms and lower legs was evaluated.
RESULTS: The overall incidence of lower legs and forearms ACS was 126/29642 (0.425%). The most common mechanisms of injury were fractures of the forearm (39/74, 52.7%), supracondylar humerus (31/74 41.9%), and elbow (4/74, 5.4%), while those for the lower legs were fractures of the proximal tibia (19/52, 36.5%), midshaft of tibia (25/52, 48.1%), and distal tibia (7/52, 13.5%). According to Flynn\'s assessment, no significant difference was observed between the two groups (p=0.151). However, the two groups showed significant differences in the hospitalization time (p=0.002) and incision infection rate (0.043).
CONCLUSIONS: Mini approaches fasciotomy combined with VSD is an effective and safe method to treat ACS of the forearms and lower legs caused by fractures in children. This method involves a single-stage surgery and is associated with shorter hospitalization time and incision infection.

The meta-analysis aimed to assess and compare diabetic foot wound ulcer management by vacuum sealing drainage. Using dichotomous or contentious random- or fixed-effects models, the outcomes of this meta-analysis were examined, and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Twenty-three examinations from 2000 to 2023 were enrolled for the present meta-analysis, including 1928 individuals with diabetic foot ulcers. Vacuum sealing drainage had significantly lower wound healing (OR, 2.35; 95% CI, 1.79-3.08, p < 0.001), lower duration of therapy (MD, -6.19; 95% CI, -10.06 to -2.32, p = 0.002), higher wound size reduction (MD, 4.22; 95% CI, 0.87-7.56, p = 0.01) and lower complication (OR, 0.32; 95% CI, 0.13-0.80, p = 0.01) compared with standard therapy in patients with diabetic foot ulcers. The examined data revealed that vacuum sealing drainage had significantly lower wound healing, duration of therapy and complication rates, as well as higher wound size reduction, compared with standard therapy in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size.

UNASSIGNED: Pressure ulcers remain a worldwide problem.
UNASSIGNED: To introduce an intermittent and feasible wound treatment method for the treatment of pressure ulcers in elderly patients.
UNASSIGNED: This surgical procedure was performed on eight elderly patients suffering from pressure ulcers. Microskin measuring 0.1 × 0.1 centimeters was cut from a small amount of thin skin and then grafted onto the wound surface in conjunction with closed negative pressure therapy.
UNASSIGNED: Seven patients had their wounds closed after a single surgery, while one patient required two surgeries to close the wound.
UNASSIGNED: Autologous microskin implantation for the treatment of pressure ulcers in the elderly is an effective method to close the wound, which can prevent the elderly from living with wounds in their later years and is a viable treatment option.

BACKGROUND: Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier\'s gangrene (FG).
METHODS: Data of patients surgically treated for FG were retrospectively analyzed.
RESULTS: Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28-74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ2 = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively.
CONCLUSIONS: VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.