Outcome analysis of vacuum assisted closure therapy in patients with open wounds
Keywords:VAC therapy, Wound, Negative pressure
Background: Vacuum assisted Closure (VAC) of wound is a recent trend and proven method of fast and better healing of wounds. The basic concept is the removal of blood and serous collection from the wound site with negative pressure and promoting the healing process rapidly by altering the local microcellular environment.The objective of the study was to show the efficacy of healing process in open wounds treated by VAC method of dressing.
Methods: In this prospective study, total of 50 patients with upper and lower limbs non-healing open wounds were recruited. Before the application of VAC, surgical debridement was performed to remove all the devitalized necrotic tissues and the wound was packed with povodine iodine. Prior to and at the end of VAC dressing, wound dimensions were noted.
Results: Patients mean age was 46.72±7.63 years and out of which 42 patients (84%) were males and 8 patients (16%) were females. All patients had suffered an acute trauma. VAC therapy was applied through continuous or intermittent suction on wounds and dressing were changed every second or third day. After application of VAC therapy all wounds showed improvement, which were indicated by presence of healthy granulation tissue, absence of necrotic tissue and subsequent wound closure.
Conclusions: VAC dressing in an open wound is an efficient and safe adjunct to treat severe infections and may be a good alternative to treat the open wounds in selected patients. Short time intervals between VAC changes and short course of therapy result in good patient acceptance. This method is recommended for all the types of non-healing wounds management.
Bihariesingh VJ, Stolarczyk EM, Karim RB, van Kooten EO. Plastic solutions for orthopaedic problems. Arch Orthop Trauma Surg. 2004;124(2):73–6.
Kramhøft M, Bødtker S, Carlsen A. Outcome of infected total knee arthroplasty. J Arthroplasty. 1994;9(6):617–21.
Clifford RP. Fraturasexpostas. Princípios AO do tratamentodefraturas. Porto Alegre: Artmed. 2002;617:40-4.
Mendonca DA, Cosker T, Makwana NK. Vacuum-assisted closure to aid wound healing in foot and ankle surgery. Foot Ankle Int. 2005;26:761-6.
Graham ID, Harrison MB, Shafey M, Keast D. Knowledge and attitudes regarding care of leg ulcers. Can FamPhys. 2003;49:897-902.
Thompson N, Gordey L, Bowles H, Parslow N, Houghton P. Reliability and validity of the revised photographic wound assessment tool on digital images taken of various types of chronic wounds. Adv Skin Wound Care. 2013;26:360-73.
Saxena V, Hwang CW, Huang S, Eichbaum Q. Vacuum assisted closure:microdeformations of wounds and cell proliferation. Plast Reconstr Surg. 2004;114:1086-96.
Bickels J, Kollender Y, Wittig JC, Cohen N, Meller I. Vacuum-assisted wound closure after resection of musculoskeletal tumors. Clin Orthop Relat Res. 2005;441:346-50.
Armstrong DG, Lavery LA. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366:1704-10.
Lavery LA, Boulton AJ, Niezgoda JA, Sheehan P. A Comparison of diabetic foot ulcer outcomes using negative pressure wound therapy versus historical standard of care. Int Wound J. 2007;4:103-13.
Kanakaris NK, Thanasas C, Keramaris N, Kontakis G. The efficacy of negative pressure wound therapy in the management of lower extremity trauma. Injury. 2007;38(5):9-18.
Smith N. The benefits of VAC therapy in the management of pressure ulcers. Br J Nurs. 2004;13:1359-65.
Kaplan M, Daly D, Stemkowski S. Early intervention of negative pressure wound therapy using Vacuum-Assisted Closure in trauma patients: impact on hospital length of stay and cost. Adv Skin Wound Care. 2009;22:128-32.
Friedman T, Westreich M, Shalom A. Vacuum assisted closure treatment complicated by anasarca. Ann Plast Surg. 2005;55(4):420-1.
Price RD, Nagarajan M, Srinivasan JR. Local anaesthetic for change of vacuum assisted closure dressing. Plast Reconstr Surg .2006;117(7):2537-8.
Cullum N, Nelson EA, Flemming K, Sheldon T. Systematic reviews of wound care management: beds, compression, laser therapy, therapeutic ultrasound, electrotherapy, electromagnetic therapy. Health Tech Assess. 2001;5(9):1270-5.
Schaum KD. Decision on national coverage of electromagnetic therapy for wounds. Adv Skin Wound Care. 2002;17(6):316-7.