Ether-Based Polyurethane Foam for Vacuum-Assisted Closure (V.A.C.) of Complicated Postoperative Abdominal Wound Dehiscence

Abstract

<jats:p> Background. The macroporous polyurethane ether foam was introduced in the medical field, as early as the 90 ties, for the Vacuum-assisted closure (V.A.C.) of a wound. We describe our experience after treating abdominal wound dehiscence in a group of elderly gynecological patients with NPWT (Negative Pressure Wound Therapy), using ether foam coated with a silver layer. We reviewed elderly patients chart data that underwent abdominal surgery complicated with wound dehiscence treated with VAC for eighteen months. In all patients, the system used was the standard GranuFoam Silver™ dressing (different extents), which was usually replaced every 48/72 h. A total of 15 consecutive female patients were included. The median age was 67.3 (58-71) years. Duration of VAC treatment was median 14.2 (11-34) days, and we saw an improvement in wound repair but also clearance of S.S.I. on the third day after applying V.A.C. Ulta™. Definitive secondary closure of the wound was obtained in all patients, as the infection�s site clearance. The abdominal VAC treatment with GranuFoam Silver™ dressing in patients with infected abdominal wound dehiscence is safe and has proper patient compliance. The latest evolution of the silver foam polyether dressing, in conjunction with NPWT therapy, offers a better antimicrobial effect and shorter healing stage. </jats:p>

Adapting surgical ‘bundles’ to prevent surgical site infections in obstetrics and gynecology (Review)

“…Negative pressure reduces the fluid accumulation and the frequency of dressing changes to every 3-5 days (37). Although there are reports that VAC does not reduce the bacterial bioburden, most cases treated this way healed without incidents potentially because the foam reacts similar to a foreign body and generates an inflammatory reaction in the surgical site, and fails to reduce the extent of bacterial colonization (38)(39)(40).…”

“…A previous study has suggested that VAC therapy speeds up the wound healing process and decreases the risk of wound complications (41). Previous studies reported a reduction of SSI incidence in several surgical fields when using VAC therapy compared with standard dressings when used on a closed surgical incision (5,40). In 2016, the World Health Organization (WHO) recommended negative pressure wound therapy on clean closed incisions as an innovative measure in high-risk patients for SSI with marked clinical results (42).…”