VAC – Prospective Study of Management of Open Wounds in Compound Fractures
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
A wound is defined as an injury creating a disruption in the normal anatomical structure and function of the skin. There are two different types of wounds: vulnus that is an acute wound, which heals according to the normal wound healing process, and ulcus that is defined as hard-to-heal wounds (previously labeled chronic wounds) such as leg ulcers, pressure ulcers and diabetic foot ulcer. These wounds have duration of more than six weeks and often show a disturbed wound healing process due to underlying causes other than direct trauma. MATERIALS AND METHODS This is a prospective study. Source of study were the 40 Cases satisfying the inclusion criteria admitted in KIMS, Hubli during the study period of November 2012 to October 2014. RESULTS 40 patients visiting KIMS hospital with open fractures of Guistilo Anderson grade 3B.Wounds were initially debrided and vacuum assisted dressing applied. Wounds were assessed depending on wound size and score before and after the application of VAC and the number of VAC settings required for uniform healthy granulation tissue formation was noted. VAC Increases the local blood flow to the wound. It considerably decreases the bacterial load of the wound and thus wound infection. VAC maintains an acidic pH and low oxygen tension on the wound which promotes granulation tissue formation and angiogenesis. Negative pressure wound therapy Induces mechanical stretch on the cell cytoskeleton leading to the release of cytokines associated with wound healing. VAC also reduce wound size, accelerates granulation tissue formation and lower the coverage complexity down the ‘reconstructive ladder’ when applied as a temporary dressing to acute open fractures. CONCLUSION The conclusions drawn from our study, Guistilo Anderson type 3 B open fractures were most commonly caused by road traffic accidents. Males were more prone than females. The most common bone involved, Vacuum assisted closure therapy appears to be a viable adjunct for the treatment of open musculoskeletal injuries, Application of sub atmospheric pressure after the initial debridement to the wounds results in an increase in local functional blood perfusion, an accelerated rate of granulation tissue formation, and decrease in tissue bacterial levels. The granulation tissue formed was healthy and uniform.
Authors and Affiliations
Dr. Gururaj Muragod, Dr. Yogesh
Keywords
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- EP ID EP434809
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