4. Discussion
low intestinal fistulas, industrial VSD, edema, colon fistulas, necrotic, abdominal wall abnormalities, infection, SSI, diabetes
EDEMA, HYPOPROTEINEMIA, NECROTIC, INFECTION, DIABETES
Many factors, including diabetes, hypoproteinemia, a high number of bacteria in the infected incision, necrotic fascia, and tissue edema,Owning to the material device utilized, industrial VSD are relatively expensive. However, based on the central concept of industrial VSD, we constructed an improved vacuum sealing drainage device (improved VSD) using inexpensive, clinically available materials and reduced the period between dressing changes to every 3 days (1–2 days). However, the current mainstream closed drainage approach has a lengthy dressing change interval (5–7 days)In clinical practice, for complex wounds, such as intestinal fistulas, particularly low intestinal fistulas and colon fistulas, the secretion is thicker mucus or feces, the diameter of the VSD drainage tube is modest, and the number of lateral apertures is fixed. Mucus and feces can obstruct the drainage tube, rendering it useless and delaying the healing time of the incision. This type of complex incision is frequently associated with abdominal wall abnormalities. The incision was large and contained several chambers. Compared to foam dressings, it is easier to pack a wound using gauze. In addition, the double-casing pipe can be inserted flexibly in accordance with the size and direction of the wound lacunae, and the number and size of the core of can be increased in accordance with the drainage characteristics. In addition, its short dressing cycle makes it easy to inspect the incision, locate infection foci missed during the initial debridement, and promptly remove dead tissue from the wound. Each time, the incision was cleansed with hydrogen peroxide and saline to minimize the quantity of bacteria in the incision and encourage wound healing. The dressing change interval was long in the VSD (5–7 days). If the initial wound debridement is insufficient or if a deep local infection is not identified, the replacement cycle will be lengthy, which will lengthen the incision healing period and increase the medical costs.The present study has several limitations. First, this was a single-center retrospective randomized clinical study, and multicenter studies should be idealized. Second, the sample size of the present clinical trial was still small because there were few the patients with suffering SSI were few during the past 3 years at the Second Affiliated Hospital of Jilin University. The reasons may be various, but the primary reason may be the increasing popularity of laparoscopic surgery, which has the advantages of being less invasive, faster recovery, and less wound, but a sample size of 61 patients was also acceptable for this retrospective study. Finally, multicenter studies with a large sample size are required to further evaluate the efficacy of improved VSD in the treatment of SSI in the future.