The Applications of Vaccum Assisted Closure(V.A.C.) for the Treatment of Chronic Wounds with Extrinsic Factors

ABSTRACT

Vacuum Assisted Closure (V.A.C.) has been reported to speed up the healing of various chronic wounds including pressure sores, stasis ulcers, cutaneous gastrointestinal fistula, hardware exposure almost due to intrinsic factors. We applied V.A.C. for the treatment of the nonhealing wounds with impaired healing mechanism due to extrinsic factors. The extrinsic factors of our cases were systemic factors that have local effects on the wound healing response, including diabetes mellitus, systemic steroid administration, chemotherapy and end stage renal disease. A total of ten patients whose wound failed conservative management over 2 weeks were successfully treated by V.A.C. therapy. The healthy granulation tissue was formed and the wounds were closed by skin graft or delayed closure. In theses cases, the positive effect of V.A.C may be the local compensation of extrinsically deviated cellular environment by dressing foam structure, continuous drainage of inhibitory wound fluid and sufficient blood supply required for inflammatory response and cell proliferation. Our results demonstrate the usefulness of V.A.C. as an adjunct in management of chronic wounds with other extrinsic factors as well as diabetes mellitus.