J Korean Surg Soc JKSS Journal of the Korean Surgical Society 1226-0053 The Korean Surgical Society 10.4174/jkss.2009.77.Suppl.S25 Case Report Successful Closure of Fasciotomy Wound by Application of Topical Negative Pressure Kang Jinmo M.D. Department of Surgery, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea. Corresponding author (Kbirdie@gilhospital.com) 12 2009 07 12 2009 77 Suppl S25 S28 25 05 2009 15 07 2009 Copyright © 2009 The Korean Surgical Society 2009

Fasciotomy wounds are a major contributor to prolonged hospital stay and can lead to amputation. Although it is generally recommended to close the fasciotomy wound as early as possible, it is usually challenging. Primary closure is more favorable because it commences more functional and esthetic results with less morbidity. But primary closure is difficult to achieve due to skin edema, retraction and necrosis. Topical negative pressure care (TNP) has been used in other areas of wound care, such as mediastinitis and burn wounds. TNP has recently gained popularity and has shown promising outcomes. Topical negative pressure systems are commercially available but very expensive. We designed a modified negative pressure system with wall-suction and applied it to a complicated fasciotomy wound. We herein report our experience with a review of related literatures.

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(A) Preparation of topical negative pressure dressing. Proper caliber chest tube is buried within the foam, thereafter this system is wrapped air-tight with surgical drapes. Caution must be addressed at the site of tube exit while wrapping. Draining-tube must be wrapped circumferentially. (B) Modified topical negative pressure system (TNP). TNP is applied at operating room using surgical drape, chest tube and foam. The air leakage test must be done at operation site by wall-suction after sealing with surgical drapes.

Final state of fasciotomy wound. The complicated fasciotomy wound can be closed successfully.

Components of VAC*. Commercially available TNP system is developed. Vacuum Assisted Closure system (VAC®, KCI, San Antonio, TX, USA).