Vacuum assisted closure: Review on current application for post-operative wound management in orthopaedics
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 2
Abstract
Background: Post operative wound dehiscence is a significant health problem. In imposes social and financial burdens. If the injury involves the exposure of bone, early coverage of the defect must be a goal of treatment to prevent secondary problems such as an osteogenic infection. Vacuum-assisted closure (VAC) therapy has been developed as an alternative to the standard forms of wound management, which incorporates the use of negative pressure to optimise conditions for wound healing and requires fewer painful dressing changes. It is a wound management system that exposes a wound bed to local negative pressure to promote healing. This article reviews the use of VAC therapy in a post operative of wound. Material and method: A prospective study conducted in department of orthopaedic surgery, Grant medical college and sir JJ Group of hospital, Mumbai from 2016-2017. A total of 25 subjects were consecutively recruited. Patients included in study are classified according to the grade of the ulcer. Patients age group 21-70 years with the following risk factors and comorbidities diabetes mellitus, hypertension, chronic obstructive pulmonary disease, dyslipidaemia, and smoking. Post operative wound dehiscence of proximal tibia, distal tibia and olecranon selected. Pre and post VAC culture collected. Patients were evaluated post VAC after definitive management for functional outcome. Result: Our study of confirms that vacuum assisted closure is an excellent treatment modality for post operative wound dehiscence. Patients had an average of 8 treatment sessions. The duration of VAC application ranged from 12 to 36 days with an average hospital stay of 24 days. Amongst this maximum patients being in the age group of 30-70 years. VAC dressing found to produce more secondary closure of wound and split skin graft, also reduced more invasive procedures like flap surgery and in worst case amputation. Also it found reduces bacterial count of the wound. Conclusion: Promotes early rehabilitation, and alleviates the need for a second procedure. Significant reduction in hospital stay subsequent lower in hospital cost, decreased amputations, increasing the number of patients undergoing skin grafting and improving culture sterility.
Authors and Affiliations
Piyush Gawai, Ujwal Ramteke, Sandeep Gavhale, Harshit Dave, Amit Yadav, Akash Mane
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