Cost Effectiveness of Vacuum-Assisted Closure and Its Modifications: A Review

Abstract

Negative topical pressure, the general category to which the trademarked VAC therapy belongs, is not a new concept in wound therapy. It is also called subatmospheric pressure therapy, vacuum sealing, vacuum-assisted closure therapy, vacuum pack therapy, and sealing aspirative therapy. The VAC therapy system is trademarked by Kinetic Concepts, Inc., or KCI. It was first reported in 1997. The aim of the procedure is to use negative pressure to create suction, which drains the wound of exudate (i.e., fluid, cells, and cellular waste that has escaped from blood vessels and seeped into tissue) and influences the shape and growth of the surface tissues in a way that helps healing. Negative-pressure therapy for the closure of wounds accelerates secondary wound healing. High cost is still a hindrance in its use in developing nations. Many modifications were tried, but their efficacy is yet to be proved. In reality, this method is quite cost effective. It is only the lack of understanding and adequate setup which makes this method hard to use. The main objective of this paper is to focus on the cost effectiveness of VAC and its modifications. We want to emphasize the importance of homemade NPT and the use of simple suction devices.

Comparison of modified vacuum dressing and wet normal saline dressing in treatment of non-healing diabetic foot ulcers

“…There are numerous trials done so far based on various variables all of which are aiming for a better faster healing, with an acceptable risk during treatment. 7 The mechanisms of action that can be attributed to NPWT therapy are an increase in blood flow-perfusion (human and animal studies), Promotion of angiogenesis (animal studies only), granulation tissue formation, Reduction in the wound surface area of several types of wounds (chronic) but not all wounds (acute), A positive modulation of the inhibitory contents in the wound fluid, there is an induction of cell proliferation (in vitro and animal studies only), reduction of oedema and bacterial clearance, removal of exudates. 8 In short it is a fact that VAC therapy, is a faster more effective and clinically proven wound healing.…”

Vacuum assisted wound healing: can it prove to be cost- effective?

“…13 The application of vacuum assisted closure is rising with advancing technology. Vacuum is seen to significantly decrease the surface area of wounds as compared to the daily dressing therapy.…”

Vacuum assisted closure technique: a short review

“…A number of clinical studies, both on animals and humans have been done so far. Most of these studies have reported the use of VAC as at par and at times better with the conventional wound closure techniques [ 16 ]. Argenta and Morykwas in the year 1997 reported the results of their study on 300 human subjects of which 296 patients responded favorably to the VAC [ 4 ].…”

“…The use of NPWT in the Indian studies has not been reported extensively. Only few Indian studies have provided insights into the NPWT use in Indian setting [ 16 , 44 - 46 ]. The NPWT using the VAC is definitely having an advantage in countries like India, where the patient load on the health centers is very high [ 47 , 48 ].…”