Abstract
Background: Vacuum-assisted dressing is a noninvasive closure system of the wound, which makes localized and controlled negative pressure. Its mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure. In this study, a patient has been presented, who suffered from serious lower extremity wounds due to arterial emboli, one of her wounds has been treated with vacuum-assisted dressing and the other with conventional dressing to evaluate the efficacy of vacuum-assisted dressing in acute ischemic wounds. Methods: A 65-year-old female patient was admitted to the emergency clinic, due to complaint of severe pain in her right lower extremity which suggested an acute arterial occlusion. She immediately underwent an embolectomy operation; however, a few days later, severe ischemia on the leg and foot became appearant. All of the necrosis was sharply debrided under sterile conditions in the operating room, and then lower leg wound was covered with vacuum-assisted dressing, also calcaneal wound was dressed with silver sulphadiazine. Results: Eighteen days after the first dressing with negative pressure, distal leg wound became ready for closure, whereas, enough granulation tissue over the calcaneal area developed merely thirty-four days later. Calcaneal wound closed spontaneously within fifty-three days. Conclusions: When dealing with this experience, using the negative pressure dressing in patient with severe lower limb wounds following arterial emboli, accelerates wound healing by means of developing the granulation tissue, and rapidly prepares the wound for closure, so it may reduce the risk of amputation.
Highlights
Vacuum-assisted dressing is a noninvasive closure system which generates localized and controlled negative pressure by which the mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure by means of delayed primary or secondary intervention
All of the necrosis was sharply debrided under sterile conditions in the operating room, and lower leg wound was covered with vacuum-assisted dressing, calcaneal wound was dressed with silver sulphadiazine
Calcaneal wound closed spontaneously within fifty-three days. When dealing with this experience, using the negative pressure dressing in patient with severe lower limb wounds following arterial emboli, accelerates wound healing by means of developing the granulation tissue, and rapidly prepares the wound for closure, so it may reduce the risk of amputation
Summary
Vacuum-assisted dressing is a noninvasive closure system which generates localized and controlled negative pressure by which the mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure by means of delayed primary or secondary intervention. Vacuum-assisted closure therapy is known as a useful tool to accelerate healing of acute, travmatic wounds, and non-healing chronic wounds, allowing a faster recovery with minimal hospital stay. It has been used widely in treatment of complex wounds such as pressure ulcers, long-term dehisced wounds, venous stasis ulcers, vascular and diabetic ulcers, gunshot wounds, postoperative sternal infections, mediastinitis and defects resulting from abdominal peritoneal resections and pelvic exenterations [4,5,6,7,8,9,10,11]. Presented here is a diabetic patient who had been suffering from multiple acute ischemic lower extremity wounds, some of which has been treated with vacuum-assisted dressing and the others with conventional dressings to evaluate the efficacy of vacuum-assisted closure in acute ischemic wounds derived from vascular obliteration
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