Vacuum therapy as an intermediate phase in wound closure: a clinical experience

Abstract 

For severely crushed, contaminated, infected or chronic wounds, vacuum therapy can act as an intermediate phase in wound closure. In this article, our clinical experience with the vacuum system is presented. The aim of this study is to evaluate vacuum therapy in wound healing in a clinical setting. From January 1997 until May 1998, we treated 26 wounds in 26 patients with a vacuum system. Eight acute, seven subacute and 11 chronic wounds were included. The wound cavity was filled with a polyurethane (PU) or a polyvinylalcohol (PVA) foam and vacuum sealed with a PU foil. A subatmospheric pressure of 125 mm mercury was maintained by a vacuum pump. Wounds were eligible for wound closure if the bacterial load score was one or less, ranging from zero to four. The median suction time was 17 days (6–55), while the median hospital stay was 49 days (9–92). Twelve wounds were closed with a split skin graft, six with a local or pedicled flap and seven with a free musculocutaneous flap. Vacuum therapy was discontinued in one patient, because of sepsis. Successful closure was achieved in 23 wounds. Vacuum therapy seems to be benificial in complicated wounds with impaired wound healing. A prospective randomized clinical trail, in which vacuum therapy is compared to conventional dressing, is in progress.