A PROSPECTIVE RANDOMIZED TRIAL OF VACUUM-ASSISTED CLOSURE VERSUS STANDARD THERAPY OF CHRONIC NON-HEALING WOUNDS

Abstract

The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds.The optimum level of negative pressure appears to be around 125 mmHg below ambient and there is evidence that this is most effective if applied in a cyclical fashion of five minutes on and two minutes off.It is believed that the negative pressure assists with removal of interstitial fluid, decreasing localised oedema and increasing blood flow.This in turn de creases tissue bacterial levels.Additionally, mechanical deformation of cells is thought to result in protein and matrix molecule synthesis, which increases the rate of cell proliferation.Despite the significant costs involved, the technique is said to compare favourably in financial terms with conventional treatments in the management of difficult to heal wounds. METHODSVAC therapy using facilities available in government. RESULTSStudy group of 20 members with 98-100% graft uptake for most used VAC therapy of 1 to 2 settings. CONCLUSIONNegative-Pressure Wound Therapy (NPWT) is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds and enhance healing of second and third degree burns.The therapy involves the controlled application of subatmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump.The use of this technique in wound management increased dramatically over the 1990s and 2000s and a large number of studies have been published examining NPWT.NPWT appears to be useful for diabetic wound and management of the open abdomen (Laparotomy), but further research is required for other wound types, always superior to normal saline dressing.