Re: A novel technique for vacuum assisted closure device application in non-contiguous wounds, by A. Culliford IV, J. Spector, J. Levine, Journal of Plastic, Reconstructive & Aesthetic Surgery, 2007;60:99–100

I read the article by Culliford et al. with interest. Although the vacuum-assisted closure (V.A.C^®, KCI, San Antonio, Texas, USA) suction system is a useful technique in managing discontinuous wounds, I disagree that it will necessarily reduce hospital costs by reducing the use of sponges and suction units. Furthermore, I do not feel it is an efficient use of dressings. The V.A.C^® suction system now comes with a number of accessories that eliminates the problem that the authors of the article have circumvented with their technique. The T.R.A.C.^® Y-connector (KCI, San Antonio, Texas, USA) allows the connection of one or more dressings to a single canister contained within a V.A.C., ATS^® (KCI, San Antonio, Texas, USA) or Freedom^® (KCI, San Antonio, Texas, USA) suction unit. So, if faced with non-contiguous wounds, the sponge dressings only need to be applied to the actual wound being treated without having to dress the bridging skin. The additional benefit of using the available accessories is that wounds on different limbs can easily be treated. Consequently, the amount of sponge and occlusive dressings required are reduced. The only extra requirements in the use of the Y-connectors compared with this method is that extra T.R.A.C^® (KCI, San Antonio, Texas, USA) pads with tubing, which sit on the sponge dressings, may be required. The costs of the dressings used in the case described have not been given. However, it is worth noting that the GranuFoam^® (KCI, San Antonio, Texas, USA) sponge is supplied as part of a kit containing the T.R.A.C^® pad and tubing, and an occlusive dressing. Therefore, if only extra sponge is required one may potentially end up wasting the TRAC pad and tubing provided in the kits.