The Department of Plastic Surgery and Interdisciplinary Surgery - Central Tropical Diseases Hospital has just successfully treated patient L.K. N (25 years old, Hanoi) with severe left thigh injury.
Previously, while moving by motorbike, the patient unfortunately collided with a 10-ton truck. The truck wheels pressed and dragged the left thigh for a long distance. Although not crossed leading to the severance of the limb, the strong pressure and tearing caused a particularly dangerous type of injury: Widespread underground skin peeling.
After a week of treatment at the lower level, the patient's left thigh was swollen, twice as deformed as the healthy side, accompanied by a necrotic skin area. MRI results showed the formation of a large empty cavity between the skin and muscles, filled with inflammatory fluid and degenerated blood.
When transferred to the National Hospital for Tropical Diseases, doctors recorded that the entire left thigh was abnormally swollen.
MSc. Dr. Nguyen Ngoc Linh (National Hospital for Tropical Diseases) said that when opening the lesion cavity, the team aspirated nearly 2 liters of fluid. "The cavity is so wide that you can put your whole hand in without touching the bottom. This is the consequence of the skin being separated from the tissue below, while the crushed muscle continuously secretes fluid" - Dr. Linh said.
According to experts, this condition is extremely dangerous. If not treated promptly, the fluid chamber will become an infection site, causing widespread necrosis, leading to septic shock and forcing amputation to save lives.
To preserve the patient's legs, doctors applied a two-stage treatment regimen.
In the early stages, the team performed surgery to remove necrotic tissue, clean the cavity, and place a negative pressure aspiration system (VAC). This device operates like a continuous "pump", helping to draw fluid from the injured area, collapse the empty cavity, and stimulate granular tissue growth. In the early days, the amount of fluid drawn was up to 200 ml per day.
After more than a week, when the inflammation was controlled and the fluid chamber was gone, doctors switched to stage two: skin grafting from the healthy thigh area to cover the missing part.
After two weeks of intensive treatment, the patient recovered well. The grafted skin area is completely alive, no more fluid buildup, and the decayed cavity has healed. Currently, Ms. N has started functional rehabilitation and is able to move almost normally in the near future.
According to MSc. Dr. Nguyen Ngoc Linh, keeping limbs in severe injuries is not only a technical success but also helps patients avoid psychological trauma and long-term burdens.
