Characteristics and treatment of skin and soft-tissue defects caused by 5·12 Wenchuan earthquake

Objective: To investigate the features and the treatment of skin and soft-tissue defects caused by 5·12 Wenchuan Earthquake.

Methods: From May 12 to June 7 in 2008, 37 injured persons (43 wounds) were treated in West China Hospital, including 20 males and 17 females with a mean age of 40 years old (range: 2 - 85). The wound locations included head (n = 2), trunk (n = 3), upper arm (n = 5), forearm (n = 5), thigh (n = 13) and lower extremity (n = 15). Their sizes ranged from 5 cm × 4 cm - 27 cm × 20 cm. In 19 cases (51.3%), the bacterial culture results of wound secretion were positive. After thorough debridement and supportive treatment, the wounds were covered by hydropathic dressings. When the infections were under control and granulation tissues grew well, the method of either skin grafting (41 wounds) or flap transposition (2 wounds) was employed to repair the wounds. The survival rate of skin flaps or free skin was used to evaluate the therapeutic efficacy.

Results: From Days 6-15 post-admission, the wounds were repaired by skin grafting or flap transposition. All free skin grafts and flaps achieved an excellent survival. Two flaps survived completely, 33 grafts survived > 95% and other 8 grafts > 90%. The stay of hospitalization lasted for 12 - 23 days. None of the patients had any symptom of severe systemic infections and all survived.

Conclusions: Skin and soft-tissue defect wounds caused by earthquake are usually present in extremities and head. And there is a high incidence of local infections and severe contaminations. Early debridement, symptomatic supports and suturing by skin or flap transposition may repair the wounds as early as possible and contribute to a rapid recovery of patients.