Title: Application of vacuum-assisted closure in the treatment of various complex wounds
Abstract: Objective To summarize the effect of surgical vacuum-assisted closure(VAC) in the treatment of vasious complex wounds, and to discuss the indications and contraindications of the technology. Methods A total of357 patients with complex wounds, hospitalized from January 2004 to August 2015, were treated with VAC. There were113 cases of post-traumatic soft tissue defects, 74 cases of diabetic foot ulcer and gangrene, 14 cases of osteomyelitis, 22 cases of postoprative poor wound healing, 37 cases of pressure ulcers, 18 cases of exposed Achilles tendon after operation, 11 cases of sious, 15 cases of Ⅲ degree burn with abscess and chronic ulcer formation, 8 cases of Ⅲ degree electrical injury, 5 cases of donor site wounds, 2 cases of deep tissue necrosis after vascular leakage, 1 case of penetrationg wound, 2 cases of skin graft wounds, 7 cases of lower limb venous ulcers, 5 cases of osteofascial compartment syndrome, 5 cases of hot crush injury, 2 cases of gouty ulcer, 5 cases of peripheral arterial ulcers, and 1 case of unexplained chronic ulcer. All the patients were given sysetemic supporting treatment in perioperative period and debridement, VAC treatment, with the fresh dressing for wounds changed 3~5 days after operation. Results After VAC treatment, the skin grafts all survived, and the wounds healed up nicely except for donor site wounds and arterial ulcers. The fresh granulation tissues were formed rapidly and had covered the deep tissue partially or totally, with the wounds shrinked. The patients suffered self-healing(6 cases), direct debidement(34 cases), autologous skin grafting(167 cases), skin flap transplantation(128 cases), artificial dermis combined with autologous skin grafting(19 cases), and conventional dressing change after wound shrinking(3 cases). During the follow-up of 6 months to 3 years, no other case of relapse was founded except that 3 cases of diabetic foot showed wound in the same parts. Three patients still had residual wounds. The total healing rate was 98.3%. Conclusion VAC has wide indications and shows significant effects on most complex wounds. It can shorten the course of treatment and improve the healing rate, but the effect is poor for donor site wounds.
Publication Year: 2016
Publication Date: 2016-01-01
Language: en
Type: article
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