Results of Vacuum Assisted Wound Closure Application
Tóm tắt
In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11–61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm2 (13.7–216.3 cm2) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7–15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions.
Tài liệu tham khảo
Gregor S, Maegele M, Sauerland S, Krahn JF, Peinemann F, Lange S (2008) Negative pressure wound therapy: A vacuum of evidence? Arch Surg 143(2):189–196
Bradley M, Cullum N, Nelson EA, Petticrew M, Sheldon T, Torgerson D (1999) Systematic reviews of wound care management: Dressings and topical agents used in the healing of chronic wounds. Health Technol Assess 3(17):1–35
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]
Vermeulen H, Ubbink DT, Goossens A, de Vos R, Legemate DA (2005) Systematic review of dressings and topical agents for surgical wounds healing by secondary intention. Br J Surg 92(6):665–672
Argenta LC, Morykwas MJ (1997) Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 38(6):563–576
DeFranzo AJ, Argenta LC, Marks MW (2001) The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 108:1184–1191
Tugcu I, Tok F, Sözeri A, Fırat Ö, Yılmaz B, Alaca R (2009) The use of “vacuum assisted wound closure-VAC” therapy in a patient with calcaneal pressure ulcer resistant to conventional methods—case report. FTR Bil Der J PMR Sci 12:34–37
Halvorson J, Jinnah R, Kulp B, Frino J (2011) Use of vacuum-assisted closure in pediatric open fractures with a focus on the rate of infection. Orthopedics 34(7):256–260
Eisenhardt SU, Momeni A, Iblher N, Penna V, Schmidt Y, Torio N, Stark GB, Bannasch H (2010) The use of the vacuum-assisted closure in microsurgical reconstruction revisited: Application in the reconstruction of the posttraumatic lower extremity. J Reconstr Microsurg 26(9):615–622
Landsman A (2010) Analysis of the SNAP wound care system: a negative pressure wound device for treatment of diabetic lower extremity wounds. J Diabetes Sci Technol 4(4):831–832
Chadwick P (2009) The use of negative pressure wound therapy in the diabetic foot. Br J Nurs 18(20):12–25
Venturi ML, Attinger CE, Mesbahi AN et al (2006) Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device. Am J Clin Dermatol 6(3):185
Chen SZ, Li J, Li XY et al (2005) Effects of vacuum-assisted closure on wound microcirculation: An experimental study. Asian J Surg 28(3):211
Saxena V, Hwang CW, Huang S et al (2004) Vacuum-assisted closure: microdeformations of wounds and cell proliferation. Plast Reconstr Surg 114(5):1086
Plikaitis CM, Molnar JA (2006) Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Devices 3(2):175–184
Kılıç A, Özkaya U, Sökücü S, Basılgan S, Kabukçuoğlu Y (2009) Use of vacuum-assisted closure in the topical treatment of surgical site infections. Acta Orthop Traumatol Turc 43(4):336–342
Demir A, Demirtaş Y, Ciftci M, Öztürk N, Karacalar A (2006) Topical negative pressure applications. Türk Plast Rekonstr Estcer Derg 14(3):171–177
Flack S, Apelqvist J, Keith M, Trueman P, Williams D (2008) An economic evaluation of VAC therapy compared with wound dressings in the treatment of diabetic foot ulcers. J Wound Care 17(2):71–78