A vacuum assisted closure system in complex wounds: a retrospective study

Abstract

IntroductionVacuum-assisted closure (V.A.C.) therapy is a dynamic and non-invasive system for improving wound healing. This novel therapy is based on applying air suction at a controlled sub-atmospheric pressure. The most important benefits of this therapy include a reduction in the wound area together with induction of new granulation tissue formation, effective wound cleansing (removal of small tissue by suction), and the continuous removal of wound exudate.The aim of this study is to describe our experience with V.A.C. therapy for complex wounds. Material and methodsWe retrospectively evaluated our experiences with V.A.C. therapy between April 2007 and August 2008. We employed a “suprafascial” V.A.C. system and an open abdomen V.A.C. system. Descriptive statistical techniques were applied and percentages and means were calculated. ResultsV.A.C. therapy was applied in 20 patients, of whom 16 (80%) had complex abdominal wounds and 4 (20%) had wounds in other locations. We employed a “suprafascial” V.A.C. system in 17 patients (85%) and an “intra-abdominal” V.A.C. system in 3 patients (15%). Two patients (10%) developed fistula during interabdominal V.A.C. therapy (urinary and enteric) but closure was achieved before therapy was finished. Mean hospital stay was 38.3 days (7–136). No mortality was directly due to the V.A.C. system. Two patients (10%) died due to their septic condition and the rest are still alive. Mean therapy length was 29.17 days (1–77) in the suprafascial group and 18 days (7–49) in the abdominal group. Average costs were €3197.97 (119.1–10780.25) per patient. ConclusionsV.A.C. therapy can improve and accelerate abdominal wound healing even in the presence of infection and bowel fistula.