Abstract
Introduction: Infections to musculoskeletal system has always been a matter of great worry to the orthopedic surgeon. Wound healing remains a challenging clinical problem to orthopedic surgeon and correct, efficient wound management remains essential in total. To overcome this complication a novel innovation in wound therapy, Negative pressure wound therapy (NPWT), also known as vacuum assisted closure (VAC) dressing, which was described initially by the Fleishmann in 1993. And was introduced in clinical practice by Argenta and Morykwas, became an important and effective tool for successful treatment of infection in complex wounds. Negative pressure wound therapy (NPWT) has been associated with low complication rate and better patient compliance by providing greater comfort as well as reducing time of hospitalization, use of antibiotics, and number of dressing changes.
Aim: The aim of this study was to evaluate the results and benefits brought by the topical application of Vacuum-assisted Closure (VAC) in patients with infected wounds of musculoskeletal system.
Methods: This prospective study was conducted in a tertiary care hospital of north India from January 2017 to December 2018. The VAC therapy was used in 52 patients having infected wound of the musculoskeletal system with male to female ratio of 1.73:1. All these wounds failed to be closed primarily or required partial thickness skin grafting (PTSG) or flap coverage. The results were presented in suitable tabular and descriptive form. The negative pressure therapy (NPWT) was applied to the infected wound after proper Wound wash and debridement, in continuous mode for an average length of treatment of 20.63 days with a negative pressure between 75 to 200 mmHg.
Results: Intermittent negative pressure was applied in all patients. The frequency of VAC dressing change was done every 4-5 days .the average number of VAC dressing used were 4.3 .the mean use of negative pressure therapy was 20.63 days. The decrease in wound size attained by VAC therapy ranged from 2.8 to 26.3cm2, with an average reduction of 12.13 cm2. All the patients showed a positive outcome with respect to wound healing and complete eradication of infection.
Conclusion: VAC has been a reliable method of treating a variety of different wounds. The dramatic result of the VAC therapy by increases the rate of granulation tissue formation and by lowering of the bacterial counts to accelerate wound healing thus significant reduction in hospital stay and the readmission with the result the burden to the both hospital and to patient has been remarkable especially in developing country with decreased inpatient capacity. The fear of the pain and discomfort to patient due to regular dressing has made the application of VAC for patient a sigh of relief.
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Corresponding Author
Dr Malik Naseer Ahmad
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.03
