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
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Article info
Publication history
Published online: June 24, 2006
Accepted:
January 1,
2006
Received:
May 24,
2005
Footnotes
☆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.
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
