Alleviating the Need for Free Flap Transfer through the Exemplary Use of Vacuum-Assisted Closure View PDF

^*Ali Adwal Ali
Department Of Surgery, College Of Medicine, University Of Kirkuk, Kirkuk, Iraq

^*Corresponding Author:

Ali Adwal Ali
Department Of Surgery, College Of Medicine, University Of Kirkuk, Kirkuk, Iraq

Published on: 2020-05-23

Abstract

Background: Vacuum-Assisted Closure (VAC) is a technique applied to various difficult cases for the treatment of acute and chronic injuries. Based on this technique, open-cell foam is applied to a suitable wound by adding a cover of adhesive dressing and then applying sub-atmospheric pressure to that wound orderly.
Aim: The main goal of this work is to alleviate the need for free flap transfer through the exemplary use of vacuum-assisted closure.
Patients and Methods: This study was carried out at Azadi teaching hospital during the period from March 2014 to August 2018. The sample consisted of 35 patients where their ages ranged between (10-58) years. The VAC technique was applied to the chronic and acute wounds to which skin graft is not applicable.
Results: A total of 35 wound sites were managed with the VAC technique. The wounds were converted from an unacceptable wound to one that can hold skin graft orderly within (10-15) days.
Conclusion: The VAC opposes the wound surface, accelerates granulation tissue in a way that can accept split skin graft.

Keywords

Acute wound; Chronic wound; VAC

Introduction

The VAC is a comparatively innovative technique applied to various difficult cases for the treatment of acute and chronic injuries [1]. This technique involves applying an open cell foam to a suitable wound by adding a cover of adhesive dressing and then applying subatmospheric pressure to that wound orderly [2]. Previous studies have reported encouraging outcomes regarding healing rates [2]. In 1997, the VAC technique was first investigated by Morykwas MJ, et al. (1997) [2] WHO suggested that the healing of wounds might be improved through applying this technique. Early works argued that the negative pressure technique increases blood flow, as demonstrated by hyperemia [3].
Delayed healing of a wound, especially in complex injuries and in aged people with comorbidities, is a key concern. It causes morbidity and lengthy treatment. Also, it may require major reconstructive surgery. This, in turn, could impose a considerable social, technical, and financial burden [4,5]. VAC is an alternative method to the management of wounds by employing negative pressure for preparing the wound for spontaneous recovery or by minor reconstructive decisions [6].