Vol. 3, Issue 1 (2017)

The use of vacuum-assisted wound closure in musculoskeletal injuries

Author(s):

Dr. Mohammed Ashraf, Dr. Sumesh Shanker. V, Dr. Savad M.P, Dr. Jinumon Mathew and Dr. Nitheesh Chandran

Abstract:
Background: This study was performed to evaluate the results of vaccum assisted wound therapy in patients with open musculoskeletal injuries or infected or exposed implant in situ (excluding arthroplasty) or traumatic wounds after debridement, infections after debridement at a tertiary care hospital, from 2013 to 2015.
Materials and Methods: 23 Patients were prospectively treated using NPWT{Negative Pressure Wound Therapy}.Mean Age of patient was 39±18yrs yrs (range,18 to 76yrs).All patients had wounds with underlying tendon or bone exposure due to RTA OR CRUSH INJURY or ACUTE TRAUMA had to be debrided before applying NPWT.T The optimal level of negative pressure appears to be around 125mmhg and is more effective as evidenced if applied in a cyclical fashion at least three times a day for 15 mins either continous or intermittent. In our study we use a sterile polyurethane sponge which is cut to suit th wound surface and placed to contact with entire wound surface. A romovac suction drain tube runs from the sponge to an another tube, which is connected to suction apparatus sponge. An adherent plastic sheet (cling drape or op sites) is used to adhere sponge to surrounding skin to form a closed system of wound.
Results: Exposed tendons, bones, raw area wounds and exposed implants were covered by granulation tissue successfully and was managed by either a skin graft or other definitive procedures. No major complication occurred that was directly attributable to treatment.
Conclusion: NPWT was found to facilitate rapid formation of granulation tissue on wounds with Exposed tendons, bones, raw area wounds and exposed implants hence shorten healing time and minimize secondary soft tissue defect coverage procedures. The technique we used is indigenous and modified as per our situation. This technique can be used in treatment of many of soft tissue injuries including degloving injuries, wounds and various soft tissue injuries prior to surgical closure, grafting or reconstructive surgeries. VAC is a cost effective and economical mode of treatment with suggestive evidence when compared with other conventional therapies with the added advantage of reduced hospital stay, no need for plastic surgery and better cosmetic acceptance.

Pages: 220-224  |  2266 Views  268 Downloads

How to cite this article:
Dr. Mohammed Ashraf, Dr. Sumesh Shanker. V, Dr. Savad M.P, Dr. Jinumon Mathew and Dr. Nitheesh Chandran. The use of vacuum-assisted wound closure in musculoskeletal injuries. Int. J. Orthop. Sci. 2017;3(1):220-224. DOI: 10.22271/ortho.2017.v3.i1d.35