Abstract
Aims
The aims of this study were to determine if vacuum assisted closure (VAC) therapy affords quicker wound closure in diabetic and ischaemic wounds or ulcers than standard treatment, if it helps debride wounds and if it prevents the need for further surgery.
Materials and methods
We retrospectively reviewed 12 patients, average aged 52.1 yrs (22 to 67) at an average of 6.3 months (1 to12 months). Seven had diabetes and three had chronic osteomyelitis. All wounds or ulcers were surgically debrided prior to application of the VAC therapy. The VAC therapy was applied according to the manufacturers instructions. The main outcome measures were the time to satisfactory healing and the change in the wound surface area.
Results
Satisfactory healing was achieved in six patients (50%), seven were diabetic and one patient had peripheral vascular disease. The average time to satisfactory healing was 2.5 months, (1 to 6 months). The average size of the wound /ulcer was 7.41 cm2 prior to treatment and 1.58 cm2 following treatment for an average 2.5 months in those in whom the wound/ulcer was still present. VAC therapy helped debride all wounds which remained sloughy following surgical debridement. In 8 patients the need for further surgery, such as soft tissue flaps or more radical surgery was avoided.
Conclusion
VAC therapy is a useful adjunct to the standard treatment of chronic wound /ulcers in patients with diabetes or peripheral vascular disease. Its use in foot and ankle surgery leads to a quicker wound closure and in some cases, avoids the need for further surgery. There are significant economic cost savings with its use in foot and ankle surgery.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
