Webb Lawrence X
Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
J Am Acad Orthop Surg. 2002 Sep-Oct;10(5):303-11. doi: 10.5435/00124635-200209000-00002.
Vacuum-assisted wound closure (VAC) is a wound management technique that exposes the wound bed to negative pressure by way of a closed system. Edema fluid is removed from the extravascular space, thus eliminating an extrinsic cause of microcirculatory embarrassment and improving blood supply during this phase of inflammation. In addition, the mechanical tension from the vacuum may directly stimulate cellular proliferation of reparative granulation tissue. Orthopaedic indications for VAC include traumatic wounds after débridement, infection after débridement, and fasciotomy wounds for compartment syndrome. VAC also can be used as a dressing for anchoring an applied split-thickness skin graft. The technique is contraindicated in patients with thin, easily bruised or abraded skin; those with neoplasm as part of the wound floor; and those with allergic reactions to any of the components that contact the skin. Clinical experience with the technique has resulted in a low incidence of minor, reversible irritation to surrounding skin and no major complications. Further experience is required, as well as clinical and basic research, to define optimal indications and benefits compared with traditional methods of wound management.
负压伤口治疗（VAC）是一种伤口管理技术，通过封闭系统使伤口床暴露于负压环境。水肿液从血管外间隙被吸出，从而消除微循环窘迫的外在原因，并在炎症阶段改善血液供应。此外，负压产生的机械张力可能直接刺激修复性肉芽组织的细胞增殖。VAC在骨科的适应证包括清创后的创伤性伤口、清创后的感染以及用于骨筋膜室综合征的筋膜切开术伤口。VAC还可作为一种敷料用于固定所植的中厚皮片。该技术对于皮肤薄、易瘀伤或擦伤的患者；伤口底部有肿瘤者；以及对任何接触皮肤的组件有过敏反应的患者禁用。该技术的临床经验表明，对周围皮肤产生轻微、可逆性刺激的发生率较低，且无重大并发症。与传统伤口管理方法相比，需要进一步的经验以及临床和基础研究来确定最佳适应证和益处。
