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Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review

  • Urology - Original Paper
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Abstract

Purpose

To determine the effectiveness of Vacuum-Assisted Closure Device in the postoperative wound care for Fournier's gangrene

Methods

We performed a systematic review in the following databases: Medline (Ovid), EMBASE, and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included RCTs and analytical observational studies. Meta-analysis was not possible given the clinical and methodological heterogeneity of the studies.

Results

We included six studies that compared VAC treated patients and a control group. The length of stay of the VAC treated vs. the conventional dressing treated patients was higher for the VAC treated patients in all but one of the included studies. The VAC group had the highest number of surgical debridements requiring anesthesia. The conventionally treated patients had a higher number of daily dressings, and the need for additional dressing changes, without anesthesia. Two studies found significantly higher mean scores for VAS, requiring a higher need for daily analgesics for the control group patients.

Conclusions

VAC therapy is an effective method, but it is not better than conventional dressing treatment. VAC carries fewer dressing changes, less pain, and less need for analgesics, but it comes with a higher need for surgical interventions requiring anesthesia.

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Author information

Authors and Affiliations

  1. Department of Surgery/Urology, School of Medicine, Universidad del Valle, Cali, Colombia

    Daniela Franco-Buenaventura & Herney Andrés García-Perdomo

  2. UROGIV Research Group, Universidad del Valle, Cll 4B, #36-00, Cali, Colombia

    Daniela Franco-Buenaventura & Herney Andrés García-Perdomo

Authors
  1. Daniela Franco-Buenaventura
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  2. Herney Andrés García-Perdomo
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Contributions

Research conception and design: DF-B, HAG-P. Data acquisition: DF-B, HAG-P. Statistical analysis: DF-B, HAG-P. Data analysis and interpretation: DF-B, HAG-P. Drafting of the manuscript: DF-B, HAG-P. Critical revision of the manuscript: DF-B, HAG-P. Administrative, technical, or material support: DF-B, HAG-P. Approval of the final manuscript: DF-B, HAG-P.

Corresponding author

Correspondence to Herney Andrés García-Perdomo.

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The authors declare we had no conflict of interest and no funding.

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Appendices

Appendix 1 Search strategies

Medline through ovid

(Exp Fournier Gangrene or (Gangrene adj2 Fournier*).mp or (Fournier* adj2 disease).mp) AND (exp Negative-Pressure Wound Therapy or (Negative-Pressure Wound Therap*).mp or (Topical Negative-Pressure Therap*).mp or (Negative-Pressure Dressing*).mp or (Vacuum-Assisted Closure*).mp).

Central through ovid

(Exp Fournier Gangrene or (Gangrene adj2 Fournier*).mp or (Fournier* adj2 disease).mp) AND (exp Negative-Pressure Wound Therapy or (Negative-Pressure Wound Therap*).mp or (Topical Negative-Pressure Therap*).mp or (Negative-Pressure Dressing*).mp or (Vacuum-Assisted Closure*).mp).

Embase through scopus

TITLE-ABS-KEY(“Fournier Gangrene” or “Fournier* disease”) AND TITLE-ABS-KEY(“Negative-Pressure Wound Therap*” or “Topical Negative-Pressure Therap*” or “Negative-Pressure Dressing*” or “Vacuum-Assisted Closure*”).

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Franco-Buenaventura, D., García-Perdomo, H.A. Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review. Int Urol Nephrol 53, 641–653 (2021). https://doi.org/10.1007/s11255-020-02705-6

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  • DOI: https://doi.org/10.1007/s11255-020-02705-6

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