Vacuum assisted closure: Review on current application for post-operative wound management in orthopaedics
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 2
Abstract
Background: Post operative wound dehiscence is a significant health problem. In imposes social and financial burdens. If the injury involves the exposure of bone, early coverage of the defect must be a goal of treatment to prevent secondary problems such as an osteogenic infection. Vacuum-assisted closure (VAC) therapy has been developed as an alternative to the standard forms of wound management, which incorporates the use of negative pressure to optimise conditions for wound healing and requires fewer painful dressing changes. It is a wound management system that exposes a wound bed to local negative pressure to promote healing. This article reviews the use of VAC therapy in a post operative of wound. Material and method: A prospective study conducted in department of orthopaedic surgery, Grant medical college and sir JJ Group of hospital, Mumbai from 2016-2017. A total of 25 subjects were consecutively recruited. Patients included in study are classified according to the grade of the ulcer. Patients age group 21-70 years with the following risk factors and comorbidities diabetes mellitus, hypertension, chronic obstructive pulmonary disease, dyslipidaemia, and smoking. Post operative wound dehiscence of proximal tibia, distal tibia and olecranon selected. Pre and post VAC culture collected. Patients were evaluated post VAC after definitive management for functional outcome. Result: Our study of confirms that vacuum assisted closure is an excellent treatment modality for post operative wound dehiscence. Patients had an average of 8 treatment sessions. The duration of VAC application ranged from 12 to 36 days with an average hospital stay of 24 days. Amongst this maximum patients being in the age group of 30-70 years. VAC dressing found to produce more secondary closure of wound and split skin graft, also reduced more invasive procedures like flap surgery and in worst case amputation. Also it found reduces bacterial count of the wound. Conclusion: Promotes early rehabilitation, and alleviates the need for a second procedure. Significant reduction in hospital stay subsequent lower in hospital cost, decreased amputations, increasing the number of patients undergoing skin grafting and improving culture sterility.
Authors and Affiliations
Piyush Gawai, Ujwal Ramteke, Sandeep Gavhale, Harshit Dave, Amit Yadav, Akash Mane
Keywords
Related Articles
- EP ID EP487130
- DOI 10.22271/ortho.2018.v4.i2m.123
- Views 104
- Downloads 0
Knee society score, mechanical tibiofemoral angle and the Fujisawa point: Do these variables determine a successful outcome of a high tibial osteotomy using an ilizarov fixator about the knee for medial compartmental osteoarthritis
Introduction: Medial compartment Osteoarthritis is an age related chronic disturbance of weight distribution over the articular surface of the knee joint. The compensatory Varus deformity which develops leads to “bowing”...
Clinical, MRI and arthroscopic correlation in menisci injuries
Medical technology sometimes obscures the importance of history taking and clinical examination, though in reality history and clinical methods are indispensable part of any patient management. In this prospective cohort...
Factors affecting the length of stay after total hip replacement; a retrospective analysis
Background: Total hip replacement is one of the most commonly performed surgical procedures. Healthcare budgets are finite. Much of the cost of total hip arthroplasty comprises the length of stay in hospital. Advancing c...
Mini open versus arthroscopic repair of rotator cuff tear: A prospective and retrospective study in rural area
Background: Rotator cuff abnormalities (including degenerative tears and those due to injury) reportedly account for up to 70% of symptoms associated with the shoulder and have significant effects on quality of life and...
Surgical management of fracture neck of femur in elderly adults with cemented bipolar hemiarthroplasty
To study the functional outcome of fracture neck of femur treated with cemented bipolar hemiarthroplasty, post operative time required for mobilization of the patient, complications related to this procedure and to study...