Abstract
The application of controlled levels of negative pressure on to a wound has been shown to accelerate evacuation of dead cells, debris and fluid which eventually encourages wound healing in a verity of surgical wounds. Vacuum Assisted Closure (V.A.C.) therapy—KCI Medical Limited, the terminology by which this is widely known, became popular, especially among the plastic surgery professionals in America and soon gained recognition worldwide. It is now widely used in the UK to manage and assist healing in a wide variety of wounds. Although KCI’s V.A.C. machines were the only ones on the market for a number of years, several wound management companies have now brought out their own machines and these are now known collectively as topical negative pressure therapy (TNPT). Traditional TNPT is often considered a relatively costly procedure. It is often used in patients with large wounds to facilitate dressing management and promote rapid cleaning and granulation. This may also allow them to be discharged to the community when they would otherwise remain inpatients, thereby saving bed days. Capital purchase of the machines is expensive and hospitals often rent or lease them on a short or long term basis. This can lead to difficulties in arranging the finances for discharge to the community. Subsequent dressing changes (recommended every 48 - 72 hrs) also incur high costs and involvement of the trained medical or nursing staff. As we all know; “Need is the mother of invention”. The disposable TNPT machine (V.A.C. ViaTM KCI Medical Ltd) has been introduced to help to solve these problems. It is a single use machine, inclusive of a dressing and canister and available off the shelf. It is very cost effective, easy to use and is used for small to moderate sized wounds. Senior author is using this machine which excellent results and illustrated the use of this machine with pictures in this paper.
Highlights
The method of using sub-atmospheric pressure for a prolonged period of time on a wound to promote debridement and wound healing was first documented by Fleischmann et al in 1993 [1]
Vacuum Assisted Closure (V.A.C.) therapy—KCI Medical Limited, the terminology by which this is widely known, became popular, especially among the plastic surgery professionals in America and soon gained recognition worldwide. It is widely used in the UK to manage and assist healing in a wide variety of wounds
KCI’s V.A.C. machines were the only ones on the market for a number of years, several wound management companies have brought out their own machines and these are known collectively as topical negative pressure therapy (TNPT)
Summary
The method of using sub-atmospheric pressure for a prolonged period of time on a wound to promote debridement and wound healing was first documented by Fleischmann et al in 1993 [1]. This topical negative pressure therapy (TNPT) dressing can be used in the treatment of many types of soft tissue wounds. The use of vacuum therapy has been described in patients with compartment syndromes of the lower limb [7] and in patients with acute and chronic infections of various types [8] and in non-healing or chronic wounds like pressure sores has been published [9,10].
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