A Comparative Study on Wound Management by Vacuum Assisted Closure With Low Cost Negative Pressure Wound Therapy and Conventional Moist Wound Dressing

ABSTRACT

Objective: Moist wound dressing (MWD) therapy,conventionally used for surgical closure after debridement,takes long time to heal and thus it creates considerable logisticand financial burden. In the present study locally developedrelatively low cost negative pressure wound healing therapy(NPWT) equipment based on the Vaccum-assisted closure(VAC) with the MWD for clinical outcome.Materials and Methods: Sixty patients with full thicknesswounds were randomly divided into two groups to be treatedwith VAC and MWD therapies. Treatment efficacy was theprimary outcome variable and it was assessed a semiquantitative scoring of wound conditions and wound surfacemeasurement. The secondary outcomes were complicationsduring therapy and postoperative duration of hospital stay.Results: Initially the proportion of the patients with differentoutcome variables (pain, pus, oedema, wound size, color,bleeding and slough) did not differ significantly between thetwo groups. At the first follow up visit after 3 days all the signsymptom, except oedema and color, started to improve atproportions which were not significantly different between thegroups. In contrast to the presence of oedema among 70%subjects in the MWD group, the sign was present only among40% case in the VAC group (p= 0.02). Similarly, dark red colorwas present in 60% case of the MWD group in contrast to only10% case of the VAC group. At the 2nd follow up visit after 6days, except oedema and color again, all the parameterimproved in the two groups in similar proportions oedema anddark red color were present among 50% and 53% subjects inthe MWD group in contrast to 10% and <10% subjects in theVAC group (p<0.05). In parallel to the earlier improvement inoedema and color (along with other features) the patients inthe VAC group could be released from the hospital earlier ascompared to the MWD group (duration of hospital stay, M±SD,6.86±1.63 in VAC vs 9.44±1.89 in MWD groups, p<0.05).Conclusions: For the treatment of wounds by NPWT, thelocally developed low cost VAC equipment is an acceptabletool with clinical effectiveness comparable to the conventionalMWD therapy and it has an added advantage for quickerclosure of the wounds.