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Vakuumtherapie und Defektdeckung beim Weichteiltrauma

Klinische Anwendung

Vacuum-assisted closure therapy and wound coverage in soft tissue injury

Clinical use

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Zusammenfassung

In der vorliegenden Arbeit wird eine Metaanalyse zur Studienlage zur VAC-Therapie in der klinischen Anwendung vorgestellt. Untersucht wurden dabei v. a. die Bereiche chronische Wunde, akute Wunde, posttraumatische Weichteildefekte, Kompartmentsyndrom und Verbrennungen. Die Publikationen wurden auf Wertigkeit, Aussagekraft hinsichtlich Komplikationen, sowie auf die Wirtschaftlichkeit des Verfahrens hin untersucht.

Die Ergebnisse der Studien werden diskutiert und daraus therapeutische Empfehlungen abgeleitet. Die Ergebnisse unserer Analyse zeigen, dass mit der Vakuumtherapie ein wertvolles Verfahren im integrierten Therapiekonzept der Weichteilrekonstruktion zur Verfügung steht, aber zu wenig prospektive klinische Studien vorliegen, um alle die im klinischen Einsatz beobachteten positiven Effekte wissenschaftlich zu untermauern und damit auch eine solide Grundlage für die wirtschaftliche Effizienz des Verfahrens zu schaffen.

Abstract

This study presents the results of a meta-analysis based on the literature dealing with the clinical applications of vacuum-assisted closure (VAC) in the areas of chronic wounds, acute posttraumatic wounds, compartment syndromes, or injuries of the upper extremities. The studies were analysed for validity, significance of conclusion with respect to success rate, publications, and economic efficacy.

The data show that with VAC a very valuable technique has been added to an integrated therapeutic concept of soft tissue reconstruction. However, clinical data from prospective randomised trials to support some of the positive aspects seen in the daily clinical application of the technique are still missing. These would create a sound basis demonstrating the economic efficacy of the technique.

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Literatur

  1. Allgöwer M (1971) Weichteilprobleme und Infektionsrisiko der Osteosynthese. Langenbecks Arch Chir 329: 1127–1136

    Article  PubMed  Google Scholar 

  2. Argenta LC, Morykwas MJ (1997) Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 38: 563–577

    Article  PubMed  Google Scholar 

  3. Armstrong DG, Lawrence AL, Abu-Rumman P et al. (2002) Outcomes of subatmospheric pressare dressing therapy on woundy of the diabetic foot. Ostomy Wound Management 44: 64–68

    Google Scholar 

  4. Banwell PE, Jones S, Evison D (2007) Topical negative pressure modulates dermal microvascular blood flow dynamics and temperature profiles at the wound dressing interface. J Wound Care (submitted)

  5. Barker DE, Kaufman JH, Smith LA et al. (2000) Vacuum pack technique of temporary abdominal closure: A 7-year experience with 112 patients. J Trauma 48: 201–206

    PubMed  Google Scholar 

  6. Blackburn JH II, Boemi L, Hall WW et al. (1998) Negative-Pressure dressings as a bolster for skin grafts. Ann Plast Surg 40: 453–457

    Article  PubMed  Google Scholar 

  7. Blight A, Fatah MF, Datubo-Brown DD et al. (1991) The treatment of donor sites with cultures epithelial grafts. Br J Plast Surg 44: 12–14

    Article  PubMed  Google Scholar 

  8. Bower CE, Kilpadi DV, Clifton C et al. (2004) Effect of negative pressure wound therapy on systemic cytokine levels in swine. Abstractband II, WUWHS Meeting, Paris 2004, ZO 32–169

  9. Braun W (1920) Zur Technik der Hautpfropfung. Zentralbl Chir 47: 135–1361

    Google Scholar 

  10. Brown GL, Nanney LB, Griffen J et al. (1990) Enhancement of wound healing by topical treatment with epidermal growth factor. N Engl J Med 321: 76–79

    Google Scholar 

  11. Burke JF, Yannas IV, Quinby WC et al. (1981) Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury. Ann Surg 194: 413

    Article  PubMed  Google Scholar 

  12. Chang KP, Tsai CC, Lin TM et al. (2001) An alternative dressing for skin immobilization: negative pressure dressing. Burns 27: 839–842

    Article  PubMed  Google Scholar 

  13. Clayton MC, Bishop JF (1998) Perioperative and postoperative dressing techniques for Integra artificial skin: Views from two medical centers. J Burn Care Rehabil 19: 358

    Article  PubMed  Google Scholar 

  14. Converse JM (ed) (1977) Reconstructive plastic surgery. Saunders, Philadelphia

  15. Dahlbäck L-O (1970) Effects of temporary tourniquet ischemia on striated muscle fibers and motor end-plates. Morphological and histochemical studies in the rabbit and electromyographical studies in man. Scand J Plast Reconstr Surg 7(Suppl): 1–91

    Google Scholar 

  16. DeFranzo AJ, Argenta LC, Marks MW et al. (2001) The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 108: 1184–1191

    Article  PubMed  Google Scholar 

  17. Deva AK, Buckland GH, Fisher E et al. (2000) Topical negative pressure in wound management. Med J Aust 173: 128–131

    PubMed  Google Scholar 

  18. Dill-Müller D, Bonovitz A, Wagner A, Tilgen W (2004) Vakuumassistierter Wundverschluss nach Exzision eines malignen Melanoms an der Ferse mit dem Fersen-Schaum (V.A.C.® V.A.C.®-Heel-Dressing). Zentralbl Chir 129: 108–112

    PubMed  Google Scholar 

  19. Domkowski PW, Smith ML, Gonyon DL Jr et al. (2003) Evaluation of vacuum-assisted closure in the treatment of poststernotomy mediastinitis. J Thorac Cardiovasc Surg 126: 386–390

    Article  PubMed  Google Scholar 

  20. Echtermeyer V (1985) Das Kompartmentsyndrom. Hefte Unfallheilkd 169: 51–65

    Google Scholar 

  21. Egniton MT, Brown KR, Seabrook GR et al. (2003) A prospective randomised evaluation of negative-pressure wound dressing for diabetic foot wounds. Ann Vasc Surg 13: 27–32

    Google Scholar 

  22. Emeri IF, Krupp S (1994) Hauttransplantation in Plastische Chirurgie Klinik und Praxis/Krupp. Ecomed, Landsberg/Lech

  23. Evans D, Land L (2001) Topical negative pressure for treating chronic wounds: a systematic review. Br J Plast Surg 54: 238–242

    Article  PubMed  Google Scholar 

  24. Fabian TS, Kaufman HJ, Lett DE et al. (2000) The evaluation of subatmospheric pressure and hyperbaric oxygen in ischemic full-thickness wound healing. Am Surg 66: 1136–1143

    PubMed  Google Scholar 

  25. Falanga V (1992) Growth factors and chronic wounds: the need to understand the microenviroment. J Dermatol 19: 667–672

    PubMed  Google Scholar 

  26. Ferbert T, Kuhfuß I, Ziegler UE (2004) Behandlung ausgedehnter Weichteildefekte an Hand und Unterarm mittels Vakuum assistierten Wundverschluss. Zentralbl Chir 129: 57–58

    Article  Google Scholar 

  27. Fleck T, Moidl R, Giovanoli P et al. (2004) Frühzeitiger Einsatz des V.A.C.©-Systems bei sternalen Wundinfektionen verhindert die Ausbreitung der Infektion auf das Mediastinum und reduziert die Notwendigkeit plastisch chirurgischer Eingriffe. Zentralbl Chir 129(Suppl 1): 35–37

    Article  Google Scholar 

  28. Fleischmann W, Lang E, Kinzl L (1996) Vakuumassistierter Wundverschluss nach Dermatofasziotomie an der unteren Extremität. Unfallchirurg 99: 283–287

    Article  PubMed  Google Scholar 

  29. Fleischmann W, Russ MK, Moch D (1998) Chirurgische Wundbehandlung. Chirurg 69: 222–232

    Article  Google Scholar 

  30. Fleischmann W, Strecker W, Bomelli M, Kinzl L (1993) Vakuumversiegelung zur Behandlung des Weichteilschadens bei offenen Frakturen. Unfallchirurg 96: 488–492

    PubMed  Google Scholar 

  31. Fleischmann W, Kinzl L (1995) Gewebeproliferation durch Vakuumtherapie (Kongressbericht 1995). Langenbecks Ann Chir 1995(Suppl II): 256–260

    Google Scholar 

  32. Ford CN, Reinhard ER, Yeh D et al.(2003) Interim analysis of a prospective, randomised trial of vacuum assisted closure versus the healthpoint system in the management of pressure ulcers. Ann Plast Surg 49: 55–61

    Article  Google Scholar 

  33. Fratianne R, Papay F, Housini I et al. (1993) Keratinocyte allografts accelerate healing of split-thickness donor sites: applications for improved treatment of burns. J Burn Care Rehabil 14: 148–154

    Article  PubMed  Google Scholar 

  34. Genecov DG, Schneider AM, Morykwas MJ et al. (1998) Pressure dressing increases the rate of skin graft donor site reepithelialization. Ann Plast Surg 40: 219–225

    Article  PubMed  Google Scholar 

  35. Godina M (1986) Early microsurgical reconstruction of complex trauma of the extremities. PRS 78: 285–296

    Google Scholar 

  36. Greer S, Kasabain A, Thorne C et al. (1998) The use of a subatmospheric pressure dressing to salvage a Gustilo grade IIIB open tibial fracture with concomitant osteomyelitis to avert a free flap. Ann Plast Surg 293: 1156–1159

    Google Scholar 

  37. Griwold JA, Cepica T, Rossi L et al. (1995) A comparison of Xeroform and Skin Temp dressing in the healing of skin graft donor sites. J Burn Care Rehabil 16: 136–140

    Article  PubMed  Google Scholar 

  38. Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 24: 742–746

    PubMed  Google Scholar 

  39. Gwan-Nulla DN, Casal RS (2001) Toxic shock syndrome associated with the use of the vacuum-assisted closure device. Ann Plast Surg 47: 552–554

    Article  PubMed  Google Scholar 

  40. Harashina T, Sawada Y, Watanabe S (1977) The relationship between venous occlusion time in island skin flaps and flap survival. Plast Reconstr Surg 60: 92–95

    Google Scholar 

  41. Harris I (1993) Gradual closure of fasciotomy wounds using a vessel loop shoelace. Injury 24: 565–566

    Article  PubMed  Google Scholar 

  42. Heimbach D, Luterman A, Burke J et al. (1988) Artificial dermis for major burns: A multi-center randomized clinical trial. Ann Surg 208: 313

    PubMed  Google Scholar 

  43. Heller G, Savolainen H, Widmer MK et al. (2003) Die gefäßchirurgische Problemwunde inguinal und die vakuumassistierte Therapie. Wur Surgery ACA 35(Suppl): 34–35

    Google Scholar 

  44. Heller G, Savolainen H, Widmer KH et al. (2004) Das Vakuumsystem in der Gefäßchirurgie. Zentralbl Chir 129: 66–70

    Article  Google Scholar 

  45. Herndon DN, Hawkins HK, Nguyen TT et al. (1995) Characterization of growth hormone enhanced donor site healing in patients with large cutaneous burns. Ann Surg 19: 649–659

    Google Scholar 

  46. Holle G, Germann G, Gregory v. H et al. (2007) VAC-Therapie Aktueller Stand der Grundlagenforschung. Unfallchirurg (eingereicht)

  47. Holle G, Peek A, Fritschen v. U, Exner K (Hrsg) (2003) Hauttransplantation unter Vakuumtherapie – Ein Konzept zur frühzeitigen Defektdeckung chronisch infizierter Wunden. Kongressband, 120. Kongress der Deutschen Gesellschaft für Chirurgie

  48. Holle G, Peek A, Fritschen v. U, Exner K (2002) Von der komplizierten Wunde zum Tissue-engineering – Besondere Indikationen für die V.A.C. Therapie. Abstractband, 33. Jahrestagung Vereinigung der Deutschen Plastischer Chirurgen, S 48

  49. Horch RE, Bach A, Loos B, Kopp J (2003) Sicherheitsaspekte und Indikationen der V.A.C.®-Therapie in der plastischen Chirurgie. Eur Surg 35: 5

    Article  Google Scholar 

  50. Horch RE, Stark GB (1994) Prosthetic vascular graft infection – defect covering with delayed vertical rectus abdominis muscular flap (VRAM) a rectus femoralis flap. VASA 23: 52–56

    PubMed  Google Scholar 

  51. Horch RE (2004) Grundlagen und Ergebnisse der Vakuumtherapie (V.A.C) in der rekonstruktiven Chirurgie. Zentralbl Chir 129(Suppl 1): 2–5

    Article  Google Scholar 

  52. Huang J, Yao YZ, Huang YK (2003) Treatment of open fracture by vaccum sealing technique and internal fixation. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 17: 456–458

    PubMed  Google Scholar 

  53. Isago T, Nozaki M, Kikuchi Y et al. (2003) Skin graft fixation with negative-pressure dressings. J Dermatol 30: 673–678

    PubMed  Google Scholar 

  54. Isago T, Nozaki M, Kikuchi Y et al. (2003) Effects of different negative pressures on reduction of wounds in negative pressure dressings. J Dermal 30: 596–601

    Google Scholar 

  55. Janzing HM, Broos PL (2001) Dermatotraction: An effective technique for the closure of fasciotomy wounds: A preliminary report of fifteen patients. J Orthop Trauma 15: 438–441

    Article  PubMed  Google Scholar 

  56. Jeschke MG, Rose Ch, Angele P et al. (2004) Development of new reconstructive techniques: use of Integra in combination with fibrin glue and negative-pressure therapy for acute and chronic wounds. Plast Reconstr Surg 113: 525–530

    Article  PubMed  Google Scholar 

  57. Jones SM, Banwell PE, Shakespeare PG (2005) Interface dressing influence the delivery of topical negative-pressure therapy. Plast Reconstr Surg 116: 1023–1028

    Article  PubMed  Google Scholar 

  58. Joseph E, Hamori CA, Bergman S et al. (2000) A prospective randomised trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds. Wounds 12: 60–67

    Google Scholar 

  59. Kamolz LP, Andel H, Haslik W et al. (2004) Use of subatmospheric pressure therapy to prevent burn wound progression in human: first experiences. Burns 30: 253–258

    Article  PubMed  Google Scholar 

  60. Karl T, Modic PK, Voss EU (2004) Indikation und Behandlungsergebnisse der V.A.C.®-Therapie in der Gefäßchirurgie – State of the art in der Behandlung chronischer Wunden? Zentralbl Chir 129: 74–79

    Article  Google Scholar 

  61. Kerrigan CL, Daniel RK (1982) Pharmacologic treatment of the failing skin flap. Plast Reconstr Surg 70: 541–549

    Article  PubMed  Google Scholar 

  62. Khouri RK, Upton J, Shaw WW (1992) Principles of flap prefabrication. Clin Plast Surg 19: 763–771

    PubMed  Google Scholar 

  63. Kopp J, Bach AD, Kneser U et al. (2004) Indikation und klinische Ergebnisse der Hautpfropfung zur Behandlung problematischer Wunden. Zentralbl Chir 129(Suppl 1): 129–132

    Article  Google Scholar 

  64. Kopp J, Hoff C, Rosenberg B et al. (2003) Application of VAC-therapy upregulates growth factor levels in neuropathic diabetic foot ulcers. Wound Repair Regeneration 11(5): 0.007

    Google Scholar 

  65. Kopp J, Strnad V, Bach AD et al. (2005) Vacuum application increases therapeutic safety ans allows intensified local radiation treatment of malignant soft-tissue tumors. Strahlenther Onkol 181: 124–130

    Article  PubMed  Google Scholar 

  66. Kremers L, Kearns M, Hammon D et al. (2003) Involvement of mitogen activated proteases kinases in wound healing during sub-atmospheric pressure therapy. Wound Repair Regeneration 11(5): 0.009

    Google Scholar 

  67. Kremers L, Wanner M, Argenta JA et al. (2003) Effects of subatmospheric pressure on PG12 and TBX-ßA2 and control of visceral blood flow post burn. Wound Repair Regeneration 11(5): 0.008

    Google Scholar 

  68. Labler L, Keel M, Trentz O (2004) Vacuum-Astisted Closure (V.A.C.®) for Temporary Coverage of Soft-Tissue Injury in Type III open Fracture of Lower Extremities. Europ J Trauma 5: 305–312

    Article  Google Scholar 

  69. Langer M, Ravenschlag C, Ochman S et al. (2004) Erfahrungen mit V.A.C.-Therapie, Fluorescein-Vital-Färbung und Integra bei einer großflächigen Avulsionsverletzung beider Beine. Zentralbl Chir 129(Suppl 1): 46–48

    Article  Google Scholar 

  70. Lister G, Scheker L (1988) Emergency free flaps to the upper extremitiy. J Hand Surg 13: 22–28

    Google Scholar 

  71. Lübken v. F, Thun-Hohenstein v. H, Weymouth M et al. (2004) Druckwerte unter VVS-Schwämmen- eine experimentelle In-vitro- und In-vito-Untersuchung. Zentralbl Chir 129(Suppl 1): 95–97

    Article  Google Scholar 

  72. Luckraz H, Murphy F, Bryant S et al. (2003) Vacuum-assisted closure as a treatment modality for infections after cardiac surgery. J Thorac Cardiovasc Surg 125: 301–305

    Article  PubMed  Google Scholar 

  73. Lundborg G (1970) Ischemic nerve injury. Experimental studies on intraneutral microcascular pathophysiology and nerve function in a limb subjected to tempory circulatory arrest. Scand J Plast Reconstruc Surg 6(Suppl): 1–113

    Google Scholar 

  74. Maitz PK, Pribaz JJ, Herggrueter CA (1996) Impact of tissue expansion on flap prefabrication: an experimental study in rabbits. Microsurgery 17: 45–49

    Article  Google Scholar 

  75. Manson PN, Anthenelli MA, Im MJ et al. (1983) The role of oxygen-radicals in ischemic tissue injury in island skin flaps. Ann Surg 198: 87–90

    Article  PubMed  Google Scholar 

  76. Marks MW, Schneider AM, Capizzi M, Morykwas MJ (eds) (1997) Muscle flap survival after complete venous occlusion by application of a negative pressure device. Paper presented at: 66th Annual Meeting of the American Society of Plastic and Reconstructive Surgeons, September 21–24, San Francisco, CA

    Google Scholar 

  77. Matsen FA, Mayo KA, Krugmire RB et al. (1977) A model compartmental syndrome in man with particular reference to the quantification of nerve function. J Bone Joint Surg Am 59: 648–653

    PubMed  Google Scholar 

  78. Matsen FA, Mayo KA, Sheridan GW, Krugmire RB (1976) Monitoring of intramuscular pressure. Surgery 9: 702–709

    Google Scholar 

  79. Matsen FA, Winquist RA, Krugmire RB (1980) Seattle, Washington. Diagnosis and management of compartmental syndromes. J Bone Joint Surg Am 62: 286–291

    PubMed  Google Scholar 

  80. Mc Callon KS, Knigth CA, Valiulus JP et al. (2000) Vacuum assisted closure versus saline-moinstened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manage 46: 28–34

    Google Scholar 

  81. Miller PR, Thompson JT, Faler BJ et al. (2002) Late fascial closure in lieu of ventral hernia: the next step in open abdomen management. J Trauma 53: 843–849

    PubMed  Google Scholar 

  82. Miller Q, Bird E, Bird K et al. (2004) Effect of subatmospheric pressure on acute healing wound. Curr Surg 61: 205–208

    Article  PubMed  Google Scholar 

  83. Milliman Studie USA (2002) Economic assessment of KCI USA‘s VAC therapy device. Milliman, USA

  84. Moisidis E, Heath T, Boorer C et al. (2004) A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg 114: 917–922

    Article  PubMed  Google Scholar 

  85. Molnar JA, DeFranzo AJ, Marks MW (2000) Single-stage approatch to skin grafting the exposed skull. Plast Reconstr Surg 105: 174–177

    Article  PubMed  Google Scholar 

  86. Molnar JA, DeFranzo AJ, Hadaegh A et al. (2004) Acceleration of integra incorporation in complex tissue defects with subatmospheric pressure. Plast Reconstr Surg 113: 1339–1346

    Article  PubMed  Google Scholar 

  87. Morykwas MJ, Argenta LC, Shelton-Brown El, McGuirt W (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38: 553–562

    PubMed  Google Scholar 

  88. Morykwas MJ, Howell H, Bleyer AJ et al. (2002) The effect of externally applied subatmospheric pressure on serum myoglobin levels after a prolonged crush/ischemia injury. J Trauma 53: 537–540

    PubMed  Google Scholar 

  89. Morykwas MJ, Faler BJ, Pearce DJ, Argenta LC (2001) Effects of varying levels of subatmospheric pressure on the rate of granulation tissue formation in experimental wounds in swine. Ann Plast Surg 47: 547–551

    Article  PubMed  Google Scholar 

  90. Moues CM, Vos MC, Bemd GJ van den et al. (2004) Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen 12: 11–17

    Article  PubMed  Google Scholar 

  91. Mubarak SJ, Hargens AR, Owen CA et al. (1976) The Wick Catheter Technique of measurement of intramuscular pressure. A new research and clinical tool. J Bone Joint Surg Am 58: 1016–1021

    PubMed  Google Scholar 

  92. Nakayama Y, Lino T, Soeda S (1990) A new method for the dressing of free skin grafts. Plast Reconstr Surg 86: 1216–1220

    Article  PubMed  Google Scholar 

  93. Nakayama Y, Soeda S (1991) A new method for free skin grafting in hands. Ann Plast Surg 26: 499–502

    Article  PubMed  Google Scholar 

  94. Neubauer G (2004) Die V.A.C.®-Therapie: Eine gesundheitsökonomische Perspektive. Zentralbl Chir 129: 122–124

    PubMed  Google Scholar 

  95. Nincovic M, Deetjen H, Oehler K, Anderl H (1995) Emergency free tissue transfer for severe upper extremity injuries. J Hand Surg Br 20: 53–58

    Article  PubMed  Google Scholar 

  96. Parrett BM, Matros E, Pribaz JJ, Orgill DP (2006) Lower extremity trauma: trends in the management of soft-tissue reconstruction of open tibia-fibula fractures. Plast Reconstr Surg 117: 1315–13224

    Article  PubMed  Google Scholar 

  97. Philbeck TE, Whittington KT, Millsap MH et al. (1999) The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare patients. Ostomy Wound Management 45: 41–50

    Google Scholar 

  98. Phillips TJ, Provan A, Colbert D, Easley KW (1993) A randomizied single-blind controlled study of cultured epidermal allografts in the treatment of split-thickness skingraft donors sites. Arch Dermatol 129: 879–882

    Article  PubMed  Google Scholar 

  99. Porter JM (1991) A comparative investigation of reepithelialization of split skin graft donor areas after application of hydrocolloid and alginate dressings. Br J Plast Surg 44: 333–337

    Article  PubMed  Google Scholar 

  100. Rejzek A, Weyer F (1998) Der Einsatz des VAC-Systems in der Therapie von Ulcus cruris und diabetischer Gangrän. Acta Chir Austriaca 150(Suppl): 12–13

    Google Scholar 

  101. Reneman RS (1975) The anterior and the lateral compartmental syndrome of the leg due to intensive use of muscles. Clin Orthop 113: 69–80

    Article  PubMed  Google Scholar 

  102. Sames CP (1977) Sealing of woundy with vacuum drainage. Br Med J II: 1123

    Google Scholar 

  103. Sasaki GH, Pang CY (1984) Pathophysiology of skin flaps raised on expanded pig skin. Plast Reconstr Surg 74: 59

    PubMed  Google Scholar 

  104. Saxena Vishal SM, Hwang CW, Huang S et al. (2004) Vacuum-assisted closure: microdeformations of wounds and cell proliferation Plast Reconstr Surg 114: 1086–1098

    Google Scholar 

  105. Scherer LA, Shiver S, Chang M et al. (2002) The vacuum assisted closure device. Arch Surg 137: 930–934

    Article  PubMed  Google Scholar 

  106. Scheufler O, Peek A, Kania NM, Exner K (2000) Beschleunigter Wundverschluss mit der VAC-Therapie. ZfW 13(2): 32–33

    Google Scholar 

  107. Schipper J, Ridder GJ, Maier W et al. (2003) Präfabrikation dreidimensionaler Lappenkonstrukte mittels Vakuumtherapie. J Wound Healing 8: 93–99

    Google Scholar 

  108. Schneider AM, Morykwas MJ, Argenta LC (1998) A new and reliable method of securing skin grafts to the difficult recipient bed. Plast Reconstr Surg 102: 1195–1198

    PubMed  Google Scholar 

  109. Schrank C, Mayr M, Overesch M et al. (2004) Ergebnisse der Vakuumtherapie (V.A.C.®-Therapie) von oberflächlich und tiefdermalen Verbrennungen. Zentralbl Chir 129(Suppl 1): 59–61

    Article  Google Scholar 

  110. Seiberlich H (2004) Wirtschaftlicher Einsatz und Überleitungsmanagement der V.A.C.®-Therapie am Beispiel. Zentralbl Chir 129: 125–128

    PubMed  Google Scholar 

  111. Sheridan RL, Hegarty M, Tompkins RG, Burke JF (1994) Artificial skin in massive burns: Result to ten years. Eur J Plast 17: 91

    Google Scholar 

  112. Song DH, Wu LC, Lohmann RF et al. (2003) Vacuum assisted closure for the treatment of sternal wounds: the bridge between debridement and definitive closure. Plast Reconstr Surg 111: 92–97

    Article  PubMed  Google Scholar 

  113. Steiert AE, Partenheimer A, Schreiber T et al. (2004) Das V.A.C.©-System (vacuum assisted closure) als bridging zwischen primärer Osteosynthese und Weichteilrekonstruktion in der Behandlung II°–III° offener Frakturen polytraumatisierter Patienten. Zentralbl Chir 129(Suppl 1): 98–100

    Article  Google Scholar 

  114. Stone P, Prigozen J, Hofeldt M et al. (2004) Bolster versus negative pressure wound therapy for securing split-thickness skin grafts in trauma patients. Wounds 16: 219–223

    Google Scholar 

  115. Su CT, Im MJ, Hoopes JE (1982) Tissue glucose and lactate following vascular occlusion in island skin flaps. Plast Reconstr Surg 70: 202–205

    Article  PubMed  Google Scholar 

  116. Teepe RGC, Koch R, Haeseker B (1993) Randomized trial comparing cryopreserved cultured epidermal allografts with tulle-gras in the treatment of split-thickness skin graft donor sites. J Trauma 35: 850–854

    PubMed  Google Scholar 

  117. Trautenhahn J, Bürger T, Lippert H (2004) Der Stand der Vakuumversiegelung. Chirurg 75: 492–497

    Article  PubMed  Google Scholar 

  118. Vanstraelen P (1992) Comparison of calcium sodium alginate (Kaltostad) and porcine xenograft (E-Z Derm) in the healing of split-thickness skin graft donor sites. Burns 18: 145–148

    Article  PubMed  Google Scholar 

  119. Wackenfors A, Sjogren J, Algotsson L et al. (2004) The effect of vacuum-assisted closure therapy on the pig femoral artery vasomotor responses. Wound Repair Regeneration 12: 224–251

    Google Scholar 

  120. Wackenfors A, Sjogren J, Gustafsson R et al. (2004) Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow: Wound Repair Regeneration 12: 600–606

    Google Scholar 

  121. Walgenbach KJ, Gratas C, Shestak KC, Becker D (1995) Ischemiainduced expression of bFGF in normal skeletal muscle: A potential paracrine mechanism for mediating angiogenesis in ischemic skeletal muscle. Nat Med 1: 453–459

    Article  PubMed  Google Scholar 

  122. Walgenbach KJ, Voigt M, Andree C et al. (2001) Management of hypovascularized wounds not responding to conventional therapy by means of free muscle transplantation. VASA 30: 206–211

    PubMed  Google Scholar 

  123. Wanner MB, Schwazl F, Strub B et al. (2003) Vacuum-assisted closure for cheaper and more comfortable healing of pressue scores: a prospective study. Scand J Plast Reconstr Surg Hand Surg 37: 28–33

    PubMed  Google Scholar 

  124. Webb LX, Schmidt U (2001) Wound management with vacuum therapy. Unfallchirurg 104: 918–926

    Article  PubMed  Google Scholar 

  125. Weed T, Ratliff C, Drake DB (2004) Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg 52: 276–280

    Article  PubMed  Google Scholar 

  126. Weinberg Croup (1999) Technology assessment of the V.A.C for in-home treatment of chronic wounds. Weinberg Group Inc., Washington, pp 1–14

  127. Whitesides TE, Haney TC, Morimoto K, Hiroshi K et al. (1975) Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop 113: 43–51

    Article  PubMed  Google Scholar 

  128. Zöch G (2004) V.A.C.-Therapie und Laser-induzierte Fluoreszenz von Indozyaningrün (IC-VIEW) – eine Bestimmung der Wundperfusion beim Diabetischen Fußsyndrom. Zentralbl Chir 129(Suppl 1): 80–81

    Article  Google Scholar 

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  1. Klinik für Plastische Chirurgie, Wiederherstellungs- und Handchirurgie, St. Markus-Krankenhaus, Frankfurt/M., Deutschland

    G. Holle

  2. Klinik für Hand-, Plastische und Rekonstruktive Chirurgie- Schwerbrandverletztenzentrum, Berufsgenossenschaftliche Unfallklinik,Klinik für Plastische und Handchirurgie an der Universität Heidelberg, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Deutschland

    G. Germann, M. Sauerbier, K. Riedel, H. Von Gregory & M. Pelzer

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  1. G. Holle
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  2. G. Germann
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  3. M. Sauerbier
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  4. K. Riedel
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  5. H. Von Gregory
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  6. M. Pelzer
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Correspondence to G. Germann.

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Holle, G., Germann, G., Sauerbier, M. et al. Vakuumtherapie und Defektdeckung beim Weichteiltrauma. Unfallchirurg 110, 289–300 (2007). https://doi.org/10.1007/s00113-007-1265-z

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