[Possibilities of preliminary treatment of infected soft tissue defects by vacuum sealing and PVA foam].

The vacuum sealing technique is a simple and cost-effective method in the treatment of traumatic and chronic soft-tissue defects. Wound cavities are filled with polyvinyl alcohol foam with embedded drainage tubes. The tubes are either drawn transcutaneously through the tissue, or placed epicutaneously, depending on the condition of the wound. The wound including the adjacent skin and the drainage tubes are covered by a transparent vapor transmitting polyurethane film. When the drainage tubes are connected with a vacuum bottle, negative pressure of 60 to 80 kPa is established. The advantages of this vacuum sealing procedure are: protection against wound contamination, complete evacuation of wound fluids independent of gravity and rapid stimulation of dense, well vascularized granulation tissue. Relief of pain and early mobilisation improve the patients comfort. Between November 1994 and July 1996, 25 patients with 28 soft tissue defects underwent this procedure. Wound closure was performed in two cases with a free flap, in five cases by a loco-regional flap, in sixteen cases with mesh-grafts, in three cases by secondary closure of the wound. Two cases were definitively treated with the vacuum sealing technique.