Role of Vacuum-assisted Closure Therapy in Management of Acute Musculoskeletal Trauma
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Background: Open fractures and concomitant so tissue defects have always been a major challenge in orthopedic surgery. Negative pressure wound therapy has recently been used in the field of orthopedics for the management of traumatic or open wounds with exposed bone, nerve, tendon, and orthopedic implants. Aims: e aim of this prospective study was to compare the effectiveness of vacuum-assisted closure (VAC) therapy with conventional dressing in the management of open musculoskeletal injuries. Materials and Methods: In a study between December 2015 and August 2017, we have included 55 cases of open musculoskeletal injuries, which were divided into two groups, one received VAC therapy while the other was treated by conventional dressing. All the patients had a thorough debridement of the primary wound followed by application of VAC therapy or treated by conventional dressing. Primary internal or external fixation was also carried out in both the groups as and where indicated. Results: The evaluation of results was based on parameters such as percentage of granulation tissue formation, improvement in the wound bed score (WBS), and preparedness of the wound bed for secondary procedures for so tissue coverage such as split-skin grafting and flap surgeries. e mean duration of therapy in VAC group was found to be 8 (±2.21) days, whereas in the control group, it was 23.96 (±8.15) days. e mean decrease in wound size in VAC group was 3.43 (±4.59) cm2, whereas in the control group, it was 0.70 (±0.88) cm2. The rate of granulation in the VAC group was found to be 98.28 (±3.29)%, while in the control group, it was 54.50 (±25.87)%, and the mean improvement in WBS in the VAC group was 14.86 (±1.00), while in the control group, it was 9.92 (±2.56). Conclusion: VAC therapy using subatmospheric pressure promotes faster wound healing by increasing local capillary perfusion and increased rate of granulation tissue formation, decreases the duration of wound healing, and requires fewer painful dressing changes with beer patient compliance. us, VAC therapy is a superior option in the management of wounds in acute musculoskeletal trauma as compared to the conventional dressing.
Authors and Affiliations
Gyanendra Senger, Kritesh Kritesh
Keywords
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Dr. KP Srivastava was born at Gorakhpur on 5th April, 1935. He did his MBBS & MS (Gen Surgery) from SN Medical College, Agra. His interest in Orthopaedics & Trauma Care took him to GSVM medical College, Kanpur where he c...
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