A clinical study of management of wounds using vacuum assisted dressings
Keywords:Wound healing, Wound dressing, Vacuum assisted closure, Negative pressure wound therapy
Background: The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. Vacuum assisted closure (VAC) has proved its efficacy for wound dressing leading to faster wound healing and shorter hospital stay. The aim of the study was to determine the advantage of vacuum assisted closure over conventional dressing in SCBMCH hospital.
Methods: The study was conducted at general surgery wards of SCB Medical College hospital. After debridement of the wound vacuum assisted dressing was applied. Control group was given conventional dressing.
Results: In the study sample 10% patients were less than 40 years, 76% belonged to 41-60 age group and 7% were more than 61 years of age, 60% male and 40% female. Wounds were located in the foot 27 (54%), leg 19 (38%), sole 2 (4%) and forearm 2 (4%). Patients with sterile pre (VAC), culture and sensitivity was not turning non sterile after VAC, but 90% non-sterile turns sterile after vacuum assisted dressing. In 5 days 25% of granulation tissue formed in VAC dressing whereas only 10% in case control. Similarly, in 10 days it was 40% for VAC and 25% in case of control. Finally, in 15 days it was 70% in case of VAC and 40% in case of control.
Conclusions: VAC results in better healing, with few serious complications, and a promising alternative for the management of various wounds.
Raffel AB. The use of negative pressure under skin flaps after radical mastectomy. Ann Surg. 1952;136:1048.
Silvis RS, Potter LE, Robinson DW, Hughes WF. The use of continuous suction negative pressure instead of pressure dressing. Ann Surg. 1955;142(2):252-6.
Fleischmann W, Strecker W, Bombelli M, Kinzl L. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg. 1993;96(9):488-92.
Morykwas MJ, Argenta LC. Nonsurgical modalities to enhance healing and care of soft tissue injuries. J Southern Orthopaedic Association. 1997;6:279-88.
Miller M, Serena T. Negative pressure wound therapy: an option for hard-to-heal wounds. Nursing Homes/Long-term Care Management. 2006;55(1):55-61.
Campbell PE, Smith GS, Smith JM .Retrospective clinical evaluation of gauze-based negative pressure wound therapy. Int Wound J. 2008;5:280-6.
Armstrong DG, Lavery LA. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366(9498):1704-10.
Kamolz LP, Andel H, Haslik W, Winter W, Meissl G, Frey M. Use of sub-atmospheric pressure therapy to prevent burn wound progression in human: first experiences. Burns. 2004;30:253-8.
Banwell PE, Teot L. Topical negative pressure (TNP): the evolution of a novel wound therapy. J Wound Care. 2003;12:22-8.
Sinha K, Chauhan VD, Maheshwari R, Chauhan N, Rajan M, Agrawal A. Vacuum Assisted Closure Therapy versus Standard Wound Therapy for Open Musculoskeletal Injuries. Adv Orthop. 2013;2013:245940.
Yadav S, Rawal G, Baxi M. Vacuum assisted closure technique: a short review. Pan Afr Med J. 2017;28:246.
James SMD, Sureshkumar S, Elamurugan TP, Debasis N, Vijayakumar C, Palanivel C. Comparison of Vacuum-Assisted Closure Therapy and Conventional Dressing on Wound Healing in Patients with Diabetic Foot Ulcer: A Randomized Controlled Trial. Niger J Surg. 2019;25(1):14-20.
Giovanni UM, Demaria RG, Otman S, Chaptal PA, Téot L. Treament of poststernotomy wounds with negative pressure. Plast Reconstr Surg. 2002;109(5):1747.
Fabian TS, Kaufman HJ, Lett ED, Thomas JB, Rawl DK, Lewis PL et al. The evaluation of subatmospheric pressure and hyperbaric oxygen in ischemic full-thickness wound healing. Am Surg. 2000;66(12):1136-43.
Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg. 2004;52(3):276-9.