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New Indian Journal of Surgery

Volume  15, Issue 3, July – September 2024, Pages 95-100
 

Original Article

Miracle Negative Pressure Wound Therapy (NPWT) or Vacuum Assisted Closure (VAC): For Difficult and Complicated Wounds: An Observational Study

Abhishek Sharma

Medical Superintendent, Senior Consultant, Director and Head of the Department, Department of Plastic Surgery and Reconstructive Surgery, All Is Well Multispeciality Hospital, Burhanpur 450331, Madhya Pradesh, India.
 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.15324.1

Abstract

In complicated wounds, healing is a challenge, particularly for the elderly with co-morbidities, which is a major concern. It can lead to prolonged treatment, pain, and morbidity and require major reconstructive procedures, which foist enormous financial and social burdens. Negative pressure wound therapy (NPWT) or vacuum-assisted closure (VAC) is a miracle and more acceptable method as an alternative in wound management that relies on sub atmospheric pressure and encourages the wound for spontaneous healing or by reducing the burden of reconstructive procedures. VAC application methods include thorough debridement, haemostasis, and the application of sterile sponge or foam dressing. A tube with fenestrations is submerged in the sponge, and the wound is wrapped to make it airtight or watertight with adhesive tape. The vacuum pump with fluid collection container is connected to the fenestrate tube. The pump delivers intermittent or continuous suction with pressure ranging from 50-55 to 120-125 mmHg. The NPW dressings are replaced on the third day. Negative pressure therapy reduces wound oedema and bacterial load, stabilizes the wound environment, improves perfusion, and stimulates angiogenesis and granulation tissue. All these mechanisms facilitate the possibility of primary wound closure and reduce the need for other reconstructive procedures. VAC therapy seems to be more effective and simpler  than traditional dressings for wound care management in reduction in wound size and volume, depth, treatment duration, and cost.
 


Keywords : VAC (vacuum-assisted closure); Negative pressure wound therapy (NPWT); Complicated and difficult wounds; Low cost; Sub-atmospheric pressure dressing
Corresponding Author : Abhishek Sharma