Vacuum Assisted Closure Therapy: Role in Modern Plastic Surgery

Objective: to share the experience of vacuum assisted closure therapy in private setup. design: descriptive setting: a private clinic for aesthetic plastic surgery,rawalpindi - pakistan. study period: june 2005 to june 2008 materials and methods: the vacuum assisted closure (vac) therapy was used in 35 patients suffering from the open wound involving various anatomical areas. all the wounds had failed to heal after treatment with multiple wound dressings and debridement. before the application of vac,surgical debridement was performed to remove all the devitalized necrotic tissues,and the wound was packed with povodine/iodine (pyodine ®). vac was applied after 24 to 48 hours. tissue cultures for micro-organisms were obtained before the application of vac and at the end of vac therapy. wound dimensions were noted prior to and at the end of vac,before the definitive treatment using skin graft or flap was performed. results: thirty-five patients were included in this study withmale to female ratio of 1.7:1. majority (40%) of the patients were 31-40 years of age. road traffic accident was the commonest cause (31.4%) followed by diabetic ulcers (17.1%). leg was most commonly effected area (31.4%). there were 28.6% diabetics,22.9% smokers and 20% hypertensives among study subjects. mean wound size decreased from 12.64x9.68-cm to 10.4x8.32-cm in non-diabetics,and from 10.5x8.7-cm to 9.0x6.4-cm in diabetic patients. mean hospital stay was 24.4 days in nondiabetics as compared to 42.6 days in diabetics. average 11.6 vacs were performed in diabetics,and 6.9 in non-diabetics. conclusion: vac is a useful adjunct to the standard treatment of chronic wounds. it is an extremely simple modality and does not require expensive equipment.