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Vacuum sealing drainage with instillation in the treatment of necrotising soft-tissue infection: a retrospective analysis

02 February 2021
12 min read
Volume 5 · Issue 1



Necrotising soft-tissue infection is a rare but life-threatening infectious disease with high morbidity and mortality. It is typically caused by toxin-producing bacteria and characterised clinically by a very rapid progression of the disease with significant local tissue destruction. In this study, we intend to explore effective wound management to control the invasive infection and to decrease the high mortality.


This retrospective analysis explored the wound management and mortality in patients with necrotising soft-tissue infection. Extensive debridement, vacuum sealing drainage (VSD) with normal saline instillation combined with broad-spectrum or sensitive antibiotics, and supportive therapies were used.


All 17 patients included in the analysis survived. The microbiology of 11 patients was found to be polymicrobial. Of the patients, 14 were discharged with completely healed wounds and three were transferred to a local hospital after the systemic and invasive wound infection was controlled.


Our experiences revealed the outstanding effect of VSD with instillation in removing the debris of necrotising tissue on the wound bed, in the continual and complete drainage of wound exudates, and in prompting wound healing.

Necrotising soft-tissue infection is a rare but life-threatening infectious disease with high morbidity and mortality. It is typically caused by toxin-producing bacteria and characterised clinically by a very rapid progression of the disease with significant local tissue destruction.1 It is further subdivided into necrotising fasciitis (or Fournier gangrene if the perineum regions are involved), necrotising myositis, necrotising adipositis and cellulitis. Rather than a single tissue infection, necrotising soft-tissue infection is commonly an infectious necrosis involving multiple tissues.

Due to its rapid progression and devastating fatal complications, necrotising soft-tissue infection is considered as an emerging and critical situation by physicians.2 Major treatments include wound management, broad-spectrum or sensitive antibiotics according to bacterial susceptibility test results, and supportive therapies. Among these therapies, wound care is the most important and most difficult because it is impossible to completely remove infectious and necrotic tissues; thus invasive infection is hard to control.3 Invasive wound infection may lead to sepsis, multiple organ dysfunction syndrome (MODS) and even death.2

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