RETRACTED ARTICLE: Evaluation of low-cost custom made VAC therapy compared with conventional wound dressings in the treatment of non-healing lower limb ulcers in lower socio-economic group patients of Kashmir valley

Abstract

BackgroundNegative-pressure wound therapy is a technique to achieve wound healing in patients with non-healing wounds of the lower limb; vacuum-assisted closure (VAC) therapy is a technique to accelerate the healing of non-healing ulcers that fail to heal on their own (primary healing) (Plast Reconstr Surg 117:193–209S, 2006).Delayed wound healing or non-healing of ulcers is a significant health problem, particularly in older adults.The efficacy of VAC dressings has been demonstrated in several randomized controlled studies, which have shown significantly faster wound healing rates compared to conventional wound therapy (Lancet 366:1704–10, 2005; J Wound Care 17:426–32, 2008). However, commercially available VAC is costly.The aim of using custom made VAC was decided by our team due to lower socio-economic status of patients taken for study who could not have afforded charges of commercially available VAC unit.ObjectiveObjective was to evaluate VAC therapy compared with conventional dressings in the treatment of non-healing lower limb ulcers in lower socio-economic patients.MethodsSixty patients of lower socio-economic status aged between 40 and 70 were prospectively studied for non-healing ulcers Wagner grade 2 or 3 and randomized into 2 groups. VAC dressing was kept for over a period of 2–7 weeks. Ulcers were treated until the wound closed spontaneously, surgically or until completion of the 50-day period, whichever was earlier.ResultsBy seventh week, discharge disappeared in 96 % in VAC and only 54 % in conventional dressing group.Granulation tissue appeared in 100 % of patients in VAC group and only 63 % in conventional dressing group. The patients treated with VAC dressing in our study showed comparable wound reduction capabilities with an average wound size reduction of 56 % in comparison to conventional dressing group which had average wound size reduction of 29 %.Majority of wounds in VAC group got closed in 7 weeks. Patient satisfaction was excellent in the majority of patients in VAC group compared to those in conventional dressing group.ConclusionThe application of VAC™ had shown good results in our study.

A A simple and low-cost technique of creating a Negative Pressure Wound Therapy (NPWT) machine on the example of a severe phlegmon of lower limb in lower socio-economic area.

“…It has been reported that a low-cost negative pressure wound therapy can be beneficial to the patients with chronic wounds of the lower extremity in lower socioeconomic groups. 4 In comparison to our study, it was based on an Indian population and the negative pressure was achieved by connecting the suction tube to a vacuum in the wall, not to the suction machine. Despite its adequacy, it has to be stated that the study had to be withdrawn because of the lack of ethics committee approval.…”

Negative‐pressure wound therapy for III/IV pressure injuries: A meta‐analysis

“…Seventeen studies were excluded for the following reasons: did not meet inclusion criteria (n = 5); not an RCT (n = 4); did not describe PIs (n = 4); did not compare with SWC (n = 2); review or case (n = 2). Sixteen studies 26‐41 , which were published from 2002 to 2017 matched the eligibility criteria and were included in the final qualitative study. All the studies consistently reported positive effects of NPWT application.…”

Reconstrucción de piel cabelluda con injerto de espesor parcial y expansor tisular secundario a mordedura de perro en paciente pediátrico

“…17 Es aconsejable apoyarse del sistema de presión negativa, en la medida que se cuente con ella, ya que (como sucedió en este caso) proporciona fijación del injerto, evita fuerzas de cizallamiento, lo mantiene húmedo y libre de acúmulo de líquidos que pudieran favorecer el desarrollo de biofilm, proliferación de microorganismos y como consecuencia la falta de integración o pérdida de éste, proporcionando excelentes resultados. 18 En 1969, Belloste propuso el realizar perforaciones a la tabla externa del cráneo para promover tejido de granulación como parte del tratamiento de lesiones en la piel cabelluda. En 1871, Netolitzky popularizó la colocación de injertos dérmicos sobre el tejido de granulación para promover una mejor cicatrización.…”

“…El uso de los injertos de espesor parcial demuestran su beneficio en la cobertura primaria, en comparación de otras técnicas; asimismo, el uso de expansores tisulares sigue siendo una herramienta vital para disminuir las secuelas estéticas. 15,[16][17][18][19][20] El manejo en este paciente demuestra que las técnicas son reproducibles y se pueden asociar los recursos actuales como el sistema de presión negativa para la reparación de heridas complejas en la piel cabelluda (SCALP). En adición, esta técnica quirúrgica es más fácil y rápida de realizar y con menos comorbilidades que otras técnicas descritas.…”