Comparing conventional gauze therapy to vacuum-assisted closure wound therapy: A prospective randomised trial

Mouës, C.M.; van den Bemd, G.J.C.M.; Heule, F.; Hovius, S.E.R.

doi:10.1016/j.bjps.2006.01.041

« Previous Next »Journal of Plastic, Reconstructive & Aesthetic Surgery
Volume 60, Issue 6 , Pages 672-681, June 2007

Comparing conventional gauze therapy to vacuum-assisted closure wound therapy: A prospective randomised trial☆

C.M. Mouës
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
- Corresponding author. Reinier de Graaf Gasthuis, Department of Surgery (Resident Plastic Surgery), P.O. Box 5011, 2600 GA Delft, The Netherlands. Tel.: +31 15 2604867; fax: +31 15 2603599.
G.J.C.M. van den Bemd
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
- Currently researcher at the Department of Urology, Erasmus University Medical Centre, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
F. Heule
- Department of Dermatology, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
S.E.R. Hovius
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands

Received 24 May 2005; accepted 1 January 2006. published online 24 June 2006.

Summary

Background

Vacuum-assisted closure wound therapy (vacuum therapy) has been used in our department since 1997 as a tool to bridge the period between debridement and definite surgical closure in full-thickness wounds. We performed a prospective randomised clinical trial to compare the efficacy of vacuum therapy to conventional moist gauze therapy in this stage of wound treatment.

Methods

Treatment efficacy was assessed by semi-quantitative scoring of the wound conditions (signs of rubor, calor, exudate and fibrinous slough) and by wound surface area measurements. Tissue biopsies were performed to quantify the bacterial load. Besides this, the duration until ‘ready for surgical therapy’ and complications encountered during therapy and postoperatively were recorded.

Results

Fifty-four patients were included (vacuum n=29, conventional n=25). With vacuum therapy, healthier wound conditions were observed. Furthermore, a tendency towards a shorter duration of therapy was found, which was most prominent in late-treated wounds. In addition, the wound surface area reduced significantly faster with vacuum therapy. Surprisingly, these results were obtained without a decrease in the number of bacteria colonising the wound. Complications were minor, except for one case of septicaemia and one case of increased tissue necrosis, which compelled us to stop vacuum therapy. For the treatment of full-thickness wounds, vacuum therapy has proven to be a valid wound healing modality.

Keywords: Clinical randomised trial, Vacuum-assisted closure wound therapy, Conventional wound therapy, Assessment of wound healing

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☆ This paper was presented, in part, at the sixth European Pressure Ulcer Advisory Panel Open Meeting, September 2002, Budapest, Hungary (poster), at the 13th Annual Educational Symposium of The Wound Healing Society, May 2003, Seattle, USA (oral) and at the 13th European Wound Management Association Conference, May 2003, Pisa, Italy (oral).This work was supported, in part, by the Plastic and Reconstructive Surgery Esser foundation, and KCI Medical, Houten, The Netherlands. The authors have no conflicts of interest to declare.

PII: S1748-6815(06)00348-2

doi:10.1016/j.bjps.2006.01.041

« Previous Next »Journal of Plastic, Reconstructive & Aesthetic Surgery
Volume 60, Issue 6 , Pages 672-681, June 2007

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