Background: This case report presents the treatment of a large infected skin defect, which was caused by an accidental explosion, through a skin-stretching device combined with vacuum sealing drainage. To the best of our knowledge, the area of the wound that we treated may currently be the largest.
Case presentation: A 41-year-old Asian man was transferred to the Center of Trauma Surgery of our hospital for the closure of an open infected wound with a large skin defect in his right lower limb caused by an accidental explosion of 100 pieces of blasting cap. The wounds located in his right gluteal were approximately 40 cm × 35 cm. On admission, the wounds had hemorrhaged, exhibiting a darkened appearance, and included scattered metallic foreign bodies. Debridement of his right gluteal area was conducted 6 hours after injury. Subsequently, a skin-stretching device combined with vacuum sealing drainage was applied to reduce the skin defect. This treatment proved to be valuable for the closure of the skin defect and to attain successful functional rehabilitation without sciatic nerve entrapment or amputation in this case.
Conclusions: It is difficult to close large skin defects, especially when they are infected. The application of a skin-stretching device combined with vacuum sealing drainage should be commonly applied to treat infected wounds because it is a safe and easy operative technique.
Keywords: Blast injury; Skin defect; Skin stretching; Vacuum sealing drainage.