A Prospective Randomized Trial of Vacuum-Assisted Closure Versus Standard Therapy of Chronic Non-Healing Wounds

Abstract

BACKGROUNDThe application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. The optimum level of negative pressure appears to be around 125 mmHg below ambient and there is evidence that this is most effective if applied in a cyclical fashion of five minutes on and two minutes off. It is believed that the negative pressure assists with removal of interstitial fluid, decreasing localised oedema and increasing blood flow. This in turn de creases tissue bacterial levels. Additionally, mechanical deformation of cells is thought to result in protein and matrix molecule synthesis, which increases the rate of cell proliferation. Despite the significant costs involved, the technique is said to compare favourably in financial terms with conventional treatments in the management of difficult to heal wounds.

Evaluation of Clinical Outcomes of Negative-Pressure Wound Therapy in Gustilo-Anderson Type IIIA/IIIB Open Fractures of Extremities

“…They concluded that VAC care aided the quick production of granulation tissue, reducing healing time and secondary soft-tissue defect-covering procedures. Similar investigations by Joseph et al [28], Morykwas and Argenta [14], and Morykwas et al [15]. found that VAC was more successful than traditional wound dressings in lowering wound widths over time.…”

Adipose-Derived Stem Cell Exosomes Facilitate Diabetic Wound Healing: Mechanisms and Potential Applications

“…In a small-sample clinical trial, Raghupathy et al indicated that Negative Pressure Wound Therapy (NPWT) significantly reduced the complete healing time of chronic wounds. 86 However, NPWT is not without limitations, including:…”

“…In a small-sample clinical trial, Raghupathy et al indicated that Negative Pressure Wound Therapy (NPWT) significantly reduced the complete healing time of chronic wounds. 86 However, NPWT is not without limitations, including: Complications: Potential complications encompass bleeding (including wound oozing and vascular bleeding), local pain, malodor, wound infection, and damage to surrounding tissues. Severe complications may precipitate septic shock, intestinal fistula, and hemodynamic instability.…”

“… [ 85 ] Hypoxia; Overexpression Circ-Snhg11 C57BL/6 Not mentioned Full-thickness round skin wound on the dorsal leg 200 μg exsomes subcutaneous injection Stronger effects of inhibiting inflammation, promoting angiogenesis and promoting macrophage M2 polarization. [ 86 ] Hypoxia; Overexpression Circ-Snhg11 C57BL Male Full-thickness round skin wound on the dorsal leg Exosome-loaded GelMA hydrogel More integrated cutaneous structure with newly formed appendages and epithelium. Collagen deposited and organized better.…”

Comparison of Vacuum Assisted Closure Technique Versus Conventional Dressing for Management of Wounds in Term of Duration of Wound Healing

“…This technique was first described by Fleischmann et al in 1993, following the successful use of this technique in 15 patients with open fractures. 5 The study reported that treatment resulted in "efficient cleaning and conditioning of wound with marked proliferation of granulation tissue". Following Fleischmann, VAC has been successfully used as an adjunct therapy in the treatment of acute and chronic soft tissue defects, defects with exposed hardware, enterocutaneous fistulae, sternotomy wounds, burns and after skin graft has been applied.…”