Functional outcome of Vacuum Assisted Closure (VAC) dressing therapy for the management of non-healing wound and traumatic wound

Abstract

Introduction: Wound healing is a complex, dynamic process and delayed wound healing significant health problem in India. Various type of surgical methods have been developed for wound healing such as Advanced Wound Care Therapies (AWCT)/ Vacuum-Assisted Closure (VAC) and myo-cutaneous or fascio-cutaneous tissue transfers, Stander dressing therapy etc. VAC Therapy is a Non-Invasive therapy. This therapeutic technique using for the management of large chronically infected wounds more recently used in the treatment of traumatic wounds and non-healing wounds. Aim: Aim of this study is to evaluate functional outcome of vacuum-assisted closure (VAC) dressing therapy for the management of non-healing wounds and traumatic wounds. Materials and methods: Our study was conducted on 30 patients in the Department of Orthopaedics, Kamineni Hospital, LB Nagar Hyderabad from May 2017 to June 2018. Out of 30 patients 18 male and 12 females, Mean age ranging from 19 to 58 for males and 20 to 60 for females. In our study, maximum cases were reported Road traffic accident 20 (67%) patients, followed by machinery injury in 6 (20%) patients and 4 (13%) patients had a fall from height. Vacuum Assisted Closure (VAC) dressing therapy applied for non-healing wounds and traumatic wounds. Results: Out of 30 wounds taken in the study, 20 wounds reduced in area & were resurfaced with split thickness skin grafting and 5 wounds showed reduction in area & were subjected to secondary closure. During start of VAC dressing therapy, all wounds were infected. At the end of VAC dressing, all wounds became swab negative during course of VAC dressing therapy, no patient required surgical debridement and there was gradual decrease in size of wound. Discussion: Our study showed that in VAC dressing therapy after day 3, there were 40% of patients who had no bacterial growth, and on day 7 there were 88% of patients who growth, whereas in saline-wet-to-moist patients only 10% of patients had no bacterial growth on the 8th day. Our study showed that VAC dressing therapy increases the vascularity and rate of granulation tissue formation compared to standard wound dressing therapy. Conclusion: VAC dressing provides sterile and controlled environment to large, educating wound surfaces by controlled application of sub-atmospheric pressure and prepares wounds for closure through split skin grafting and secondary closure in short time leading to less overall morbidity with decreased hospital stay.