A STUDY OF NEGATIVE PRESSURE WOUND THERAPY: VACUUM ASSISTED CLOSURE IN CHRONIC NON-HEALING ULCERS

BACKGROUNDThis study evaluates the advantage of Negative Pressure Wound Therapy-Vacuum Assisted Closure over Conventional Dressing in the management of chronic non-healing ulcers. METHODSFrom June 2014 to June 2015, 50 patients were selected (25 cases and 25 controls).After wound debridement, VAC dressing is applied.Pre VAC and post VAC culture and sensitivity is taken.Dressing is given for 72 hours and intermittent suction is given for 10 mins. in an hour, daily for 12 hours with negative pressure ranging from 100 to 125 mmHg.Rest of the time drain of the VAC dressing is connected to the Romovac suction drain.Doppler study to assess the vascularity of the limb before the procedure and X-ray is taken to rule out osteomyelitis.Control group patients are given conventional dressings. RESULTSThe gender, age and ulcer distributions were almost equal in the case and control groups and were found to be statistically insignificant.Duration of hospital stay in days was found to be statistically significant between groups.Majority (52%) of cases left hospital within 3 weeks' time, while a major chunk (88%) of control population stayed more than 3 weeks.VAC dressing shows better results in patients with normal Doppler study.VAC dressing have better results in patients with 48% undergoing split skin grafting and less rate (8%) of amputation as against none undergoing split skin grafting and 24% needing amputation in the control group.Patients with sterile pre-VAC culture were not turning unsterile after VAC, but 90% unsterile turns sterile after VAC. CONCLUSIONNPWT is a novel technique for managing an open wound by submitting the wound either to intermittent or continuous subatmospheric pressure.Here, we did a study to study the advantage of vacuum assisted closure over conventional dressing in the management of chronic non-healing ulcers and concluded that VAC decreases hospital stay, improves pus culture sterility, has better result in patient with normal Doppler, improves outcome by decreasing the number of amputations and increases the number of patients undergoing split skin grafting.