Vacuum-Assisted Closure Therapy

Figure 3: The mechanism of VAC therapy: improvement of tissue perfusion, reduction of bacterial load and edema.

Conclusion

After 20 years of experience with vacuum-assisted closure, we can state that VAC therapy contributes positively to wound treatment. Wounds treated with this procedure are easier to manage, both in the hospital and at home. It can be used on a wide variety of chronic and acute wounds, and more applications are being developed. The procedure also reduces hospitalization time and expenses, and perhaps most important, it improves the patient’s quality of life. TH

M. Leijnen, MD, MSc, and S.A. da Costa, MD, PhD, practice in the Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands. L. van Doorn, MA-NPA, practices in the Rijnland Wound Centre, Leiderdorp, The Netherlands. P. Steenvoorde, MD, MSc, and J. Oskam, MD, PhD practice in the Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands, and in the Rijnland Wound Center, Leiderdorp, The Netherlands.

Figure 4: Treatment of an infected elbow fracture after closed reposition with VAC. This demented patient removed the suturing manually, which caused an infection in the left elbow. The wound was adequately debrided (A). To close the wound, VAC therapy was started (B). The wound granulated successfully with VAC therapy (C). Afterward, the wound was closed with a split skin graft (D). The function of the elbow is impaired; however, the patient is free of pain and infection.

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