Abstract
Purpose: To evaluate the efficacy of VAC in wound healing.
Materials and Methods: This prospective study was done from September 2016 to August 2017 over 20 patients who presented in our hospital with severe wounds. These wounds were either traumatic, idiopathic or iatrogenic; either infective or non-infective. We had 13 males and 7 females in our study, with age ranging from 15 to 65 years. VAC was applied to all the wounds in continuous mode at pressure of 125 mmHg. The parameters assessed were nature of the wound, status of infection along with infecting organism, length of VAC application, number of dressings required and complications, if any, related to the use of this therapy. All patients were followed for a period of 3 months.
Results: Among 20 patients, we lost 1 patient in follow-up. Rest 19 patients (95%) were treated successfully. Cost of dressings was less. There was a significant reduction in wound infection in infected cases and a rapid rate of granulation tissue formation in all cases. Grafting in the form of PTSG was seen in all the grafted patients. There was no major complication.
Conclusion: VAC is a safe and reliable option in the treatment of wounds with better healing, graft uptake and reduced hospital stay. It appears as a promising alternative for the management of various wound types including infected wounds.
Keywords: Wound healing, Vacuum assisted closure.
References
- Gregor S, Maegele M, Sauerland S, Krahn JF, Peinemann F, Lange S ( 2008) Negative pressure wound therapy: A vaccum of evidence? Arch Surg 143(2):189-196
- Bradley M, Cullum N, Nelson EA, Petticrew M, Sheldon T, Torgerson D. Systematic reviews of wound care management: Dressings and topical agents used in the healing of chronic wounds. Health Technol Assess. 1999;3 (17):1–35. [PubMed]
- Dryburgh NSH, Donaldson J, Mitchell M, Smith FC (2006) Debridement for surgical wounds. Cochrane Database of Systematic Reviews 2006, Issue 4. [Art. No.: CD006214. doi: 10.1002/14651858.CD006214] [PubMed]
- Vermeulen H, Ubbink DT, Goossens A, de Vos R, Legemate DA. Systematic review of dressings and topical agents for surgical wounds healing by secondary intention. Br J Surg. 2005;92(6):665–672. doi: 10.1002/bjs.5055. [PubMed] [Cross Ref]
- Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997; 38(6):563–576. doi: 10.1097/00000637-199706000-00002. [PubMed] [Cross Ref]
- De Franzo AJ, Argenta LC, Marks MW. The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg. 2001;108:1184–1191. doi: 10.1097/00006534-200110000-00013. [PubMed][Cross Ref]
- Fleischmann W, Strecker W, Bombelli M, Kinzl L. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg 1993;96:488-92.
- Lionelli GT, Lawrence WT, Wound dressings. SurgClin North Am. 2003;83:617-638.
- Bucalo B, Eaglstein WH, Falanga V. Inhibition of cell proliferation by chronic wound fluid. Wound Repair Regen 1993;1:181-186.
- Webb LX, Schmidt U. Wound manage-ment with vacuum therapy. Unfallchirurg 2001; 104: 918-926.
- Bouree M, Kozianka J, Die V.A.C. Therapie in der Allgemeinchirugie. European Society ACA 2003;191(Suppl 35):45-38
- Loree S, dompmartin A, Penven K, Harel D, Leroy D. Is Vacuum Assisted Closure a valid technique for debriding chronic leg ulcers? J Wound care 2004; 13: 249-252
- Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg.1997;38:553-562.
- Chen SZ, Li J, Li XY, Xu LS. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg, 2005; 28:211
- Morykwas MJ, Argenta LC, Shelton-Brown EI, et al. Vacuum-assisted closure: a new method forwound control and treatment: animal studies and basic foundation. Ann Plastsurg 1997;38:553-62
- Banxell PE, Teot L. Topical negative pressure (TPN): the evolution of a novel wound therapy. J Wound care 2003:12:22-8.
Corresponding Author
Irfan Andleeb Gul
Senior Resident, Orthopaedics at Hamdard Institute of Medical Sciences and Research, New Delhi
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.172
