Abstract
Use of topical negative pressure over difficult-to-heal wounds has been studied. The objective of this study was to analyze the effects from negative pressure in the treatment of complex wounds. Case series developed at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. Twenty-nine patients with complex wounds were treated with the vacuum system and then underwent a surgical procedure to close the wound. 85% of the skin grafts took well, and 87.5% of the local flaps were successful, thus demonstrating adequate wound preparation. The wounds were closed within shorter times than observed using other conventional treatments In two cases, the vacuum system was also used to stabilize the skin grafts over the wounds. Use of the vacuum method is safe and efficient for preparing wounds for surgical closure. It allows for an improvement of local wound conditions, and healthy granulation tissue develops with control over local infection.
Highlights
Treatment of wounds is one of the most challenging situations that a plastic surgeon can face
In a study conducted in our hospital, about 8% of the patients had chronic wounds, and this situation may be more critical in geriatric hospitals or intensive care units.* The wounds included pressure sores, wounds on diabetic feet, and wounds of vascular origin
Twenty-nine patients with complex wounds were treated in a tertiary hospital
Summary
Treatment of wounds is one of the most challenging situations that a plastic surgeon can face. The wide range of dressings and drugs that are available for treating chronic wounds means that it is not always clear which of these is most indicated. Recent studies have shown the importance of faster treatment of wounds among in-hospital patients in order to reduce such costs. The treatment of complex wounds has changed greatly in wound centers over the last decade. It has included aggressive surgical debridement for removal of necrotic tissue, allowing better control over local infection. The wound bed should be prepared so as to lead to the formation of healthy granulation tissue and reach the third stage: surgical closure using skin grafting, local flaps or microsurgical flap transplantation. Wound contraction and spontaneous epithelization should be kept to a minimum, avoiding prolonged hospital stay and recurrence of infection
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