Wound vacuum-assisted closure for Fournier's gangrene: A new technique for applying a vacuum-assisted closure device on multiple wound sites using minimal connectors

Abstract

The use of a vacuum-assisted closure (VAC) device has been associated with accelerated development of granulation tissue, earlier re-epithelialization of wounds, and faster closure of complex wounds than traditional dressings. Extensive and multiple wounds can present a challenge to traditional VAC use, especially when the wounds are separated by areas of normal tissue. A 56-year-old obese diabetic female presented with a lesion on her inner thigh. She had a 2 cm lesion on her inner thigh that was draining a grayish fluid. Extensive crepitus was palpated on both thighs and her perineum. She was diagnosed with an advanced Fournier's gangrene. An extensive debridement of all involved tissue was performed, including her labia and perineum, mons pubis, buttocks, left leg to the level of the knee, and right leg to mid-thigh level. We elected to use a VAC device for wound management. Given the complexity and extent of her wound, the traditional method of one sponge and suction tubing per wound would have required several negative-pressure devices. We devised a method using bridges of VAC foam that were effective for closing this complex series of wounds, requiring only a single negative-pressure device and two connectors. The following core competencies are addressed in this article: Medical knowledge, Patient care. Republished with permission from: Pryor III R, Sparks D, Chase D, Bogen G. Wound VAC for Fournier's gangrene: A new technique for applying a vacuum-assisted closure device on multiple wound sites using minimal connectors. OPUS 12 Scientist 2009;3(3):47-49.