OBJECTIVETo explore clinical effect of vacuum sealing drainage (VSD) combined with discontinuous windowing technique for repairing large area exposed wounds of Achilles tendon.

METHODSFrom July 2009 to May 2014, 11 patients with large exposed wounds of Achilles tendon were treated, including 5 males and 6 females with an average age of 43 years old (aged from 7 to 65 years old). Among them, 4 cases were skin necrosis caused by heavy objects abrasion and contusion; 3 cases were caused by distal tibiofibula fractures; 3 cases were caused by bicycle-spoke injuries; 1 case was caused by diabetes. Areas of exposed Achilles tendon were from 6 cmx3 cm to 14 cmx5 cm without tendon rupture or bone exposed. After debridement, discontinuous fenestration on Achilles tendon was made by knife blade parallel with longitudinal axis of Achilles tendon, combined with Vacuum Sealing Drainage (VSD) treatment.

RESULTSAfter drainage treatment with one VSD cycle (5 to 7 days), abundant fresh granulation tissues were growing on all wounds and survived well after the second phase dermatoplasty. All patients were followed up for 12 to 24 months, the color of skin flap was good, the texture was soft without burst. At 3 to 4 months after operation, subcutaneous fat was appeared under the flap, the skin was sliding, movement of ankle joints was good. No delayed Achilles tendon rupture were occurred.

CONCLUSIONVacuum sealing drainage (VSD) combined with discontinuous fenestration is a simple, safe and effective method for repairing large area exposed wounds of Achilles tendon,which could minimize the secondary damage caused by wounds of skin flap grafting.