Sari Alper, Fesli Atilla, Yener Tolga, Basterzi Yavuz, Demirkan Ferit
Mersin University, Mezitli/Mersin, Turkey; Email:
Wounds. 2009 Apr;21(4):95-101.
This study evaluates the efficacy of a vacuum-assisted closure (V.A.C.® Therapy, KCI, San Antonio, Tex) device in the comparative management of clean and infected wounds. Vacuum-assisted closure was applied to 57 wounds of 51 patients.
Our protocol consisted of debridement of all necrotic tissue followed by vacuum-assisted closure therapy along with appropriate antibiotic administration. In 5 cases with peripheral circulation impairment, vacuum-assisted closure therapy was terminated due to a poor tissue response. In the remaining 52 wounds, healthy granulation tissue generation was observed. Wound cultures obtained from these patients prior to the start of vacuum-assisted closure proved the presence of infection in 31 wounds, while the other 21 wounds were free of infection.
The average sizes of the infected and non-infected wounds were 55.77 cm2 and 57.94 cm2 prior to the start of vacuum-assisted closure, respectively, while they were reduced to 48.28 cm2 and 45.70 cm2 after the last session. At the conclusion of vacuum-assisted closure therapy, 42 wounds were skin grafted and 10 wounds were covered with skin/muscle flaps.
Vacuum-assisted closure therapy is a reliable tool in the management of almost any type of wound, whether infected or not infected, unless major circulatory impairment interferes and acted as a contributory factor in wound formation. .
本研究评估了负压封闭引流（V.A.C.® 疗法，KCI，得克萨斯州圣安东尼奥）装置在清洁伤口和感染伤口对比处理中的疗效。对51例患者的57处伤口应用了负压封闭引流。
我们的方案包括清除所有坏死组织，随后进行负压封闭引流治疗并给予适当的抗生素。5例伴有外周循环障碍的患者，因组织反应差而终止负压封闭引流治疗。在其余52处伤口中，观察到健康肉芽组织生成。在开始负压封闭引流之前从这些患者获取的伤口培养物显示，31处伤口存在感染，而其他21处伤口未感染。
在开始负压封闭引流之前，感染伤口和未感染伤口的平均面积分别为55.77平方厘米和57.94平方厘米，而在最后一次治疗后分别减小至48.28平方厘米和45.70平方厘米。在负压封闭引流治疗结束时，42处伤口进行了植皮，10处伤口用皮肤/肌瓣覆盖。
负压封闭引流治疗是处理几乎任何类型伤口（无论是否感染）的可靠工具，除非严重的循环障碍干扰并成为伤口形成的促成因素。
