Application of Vacuum-assisted Closure in Difficult Wounds

Heun Guyn Jung; Sungchan Ki; Byunghak Kim; Kwanwoo Kim; Yungkyung Kim; Yugyung Cho; Yongsoo Choi

doi:10.4055/jkoa.2012.47.1.41

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Jung, Ki, Kim, Kim, Kim, Cho, and Choi: Application of Vacuum-assisted Closure in Difficult Wounds

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(1): 41-47.

Published online: 29 February 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.1.41

Application of Vacuum-assisted Closure in Difficult Wounds

Heun Guyn Jung, M.D., Sungchan Ki, M.D., Byunghak Kim, M.D., Kwanwoo Kim, M.D., Yungkyung Kim, B.S.N., Yugyung Cho, B.S.N., Yongsoo Choi, M.D.

Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Correspondence to: Yongsoo Choi, M.D. Department of Orthopaedic Surgery, Kwangju Christian Hospital, 264, Yangrim-dong, Nam-gu, Gwangju 503-715, Korea. TEL: +82-62-650-5060, FAX: +82-62-650-5066, stemcellchoi@yahoo.co.kr

Received 24 May 2011 Revised 23 July 2011 Accepted 24 September 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We analyzed the usefulness of vacuum-assisted closure (VAC) dressing to facilitate the healing of difficult wounds by comparing the results of conventional dressings.

Materials and Methods

We selected 20 cases for the experimental group (VAC group) and 20 cases for the control group (conventional dressing), and investigated the change in wound size, formation of granulation tissue, and duration of wound healing in the two groups.

Results

In the VAC group, the size of wound decreased from 60.2±59.1 cm² to 29.7±18.8 cm² (p=0.001). In the control group, it decreased from 60.3±83.3 cm² to 34.4±47.6 cm² (p=0.04). For formation of granulation, it increased from 1.2±0.4 to 2.7±0.6 (p=0.001) in the VAC group and from 1.2±0.4 to 2.4±0.5 in the control group. For the duration of healing, it took 17.5±8.3 days for the VAC group and 22.9±22.0 days in the control group (p=0.857). However there were no statistically significant differences in all the parameters between the 2 groups (p>0.05).

Conclusion

The clinical application of VAC to difficult wound yield comparable results in terms of a decrease in wound size, formation of granulation, and the duration of healing. VAC dressing could be an alternative treatment option for a difficult wound considering the advantage of saving medical human resources.

Keywords: wound, wound healing, vacuum-assisted closure

Figures and Tables

Figure 1

Comparison of the wound size between the CD group and the VAC group. VAC, vacuum-assisted closure; CD, conventional dressing.

Figure 2

Changes in the grade of granulation between the CD group and the VAC group. VAC, vacuum-assisted closure; CD, conventional dressing.

Figure 3

The difference in the period of dressing between the CD group and the VAC group. VAC, vacuum-assisted closure; CD, conventional dressing.

Figure 4

Clinical application of VAC for a 70-year-old female with diabetes mellitus foot (A) about 15×10 cm sized necrotic soft tissue infection developed on the left foot due to burn. (B) Debridement was performed. (C) After application of VAC for 2 weeks, the size of defect decreased to 10×3 cm. (D) Then, a full thickness skin graft was performed. VAC, vacuum-assisted closure.

Table 1

The Summary of Data of VAC Group (Experimental Group)

VAC, vacuum assisted closure; M, male; F, female; L/W, laceration wound; Rt, right; Lt, left; MRSA, methicillin resistant Staphylococcus aureus; FTSG, full thickness skin graft; A. baumannii, Acinetobacter baumannii; S. aureus, Staphylococcus aureus; ALT flap, anterolateral thigh flap.

Table 2

The Summary of Data of the Conventional Dressing Group (Control Group)

WM, wound management; F, female; M, male; Lt, left; Rt, right; fx., fracture; FTSG, full thickness skin graft; comm., comminution; S. agalactiae, streptococcus agalactiae; P. aerugosa, Pseudomonas aeruginosa; ALT, anterolateral thigh; STSG, split thickenss skin graft.

Table 3

Grade of the Wound Granulation

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