Role of Vacuum-assisted closure therapy in the management of chronic wounds

Abstract

Vacuum-assisted closure (VAC) therapy is a relatively new concept described in the literature that increases wound-healing capacity. The aim is to investigate the effect of vacuum-assisted closure therapy on wound healing and granulation tissue formation and hence shortening of the wound bed preparation time, reduction in duration of hospital admission, and reduction in the necessity for dressing change or for debridement. Sixty-eight patients with chronic wounds were randomized to initial treatment with vacuum-assisted closure or conventional dressings. Depending upon the condition of the wound, it was debrided and dressing changed. The rate of granulation tissue production was determined by measuring the reduction in wound volume over time. The primary endpoint was a granulated wound or preparation for wound coverage techniques. The mean wound size before treatment was 26.52 cm2 and 15.84 cm2 in VAC therapy and conventional dressing group respectively. Similarly, the mean wound size after treatment was 13.35 cm2 and 14.38 cm2 in VAC therapy and conventional dressing group respectively. The duration of treatment was 14.71 days and 23.38 days with % of wound size reduction 49.66% and 9.21% in VAC therapy and conventional dressing group respectively were statistically significant. The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in chronic wounds. It also provides a sterile, more controlled resting environment to large exudating wound surfaces.