Ten years’ experience of vacuum systems in treatment of complicated postoperative wounds of various etiologies

Abstract

Objective: increase effectiveness of wounds treatment after various etiology by using VAC.Materials and methods: study included 128 patients with surgical infection. Specter of operations is presented: pilonidal cyst excision — 40 (31.2%), sternomediastinitis — 23 (18%), mesh hernioplasty — 16 (12.5%), laparotomy — 15 (11.7%), emergency laparotomy — 7 (5.5%), traumatology paraimplant complications — 7 (5.5%), abdominoplasty — 7 (5.5%), postoperative esophageal fistulas — 6 (4.7%), decubital ulcers — 4 (3.1%), mammoplasty — 3 (2.3%).Results: duration of VAC-therapy averaged 22.1±0.26 days. Systemic inflammatory reaction noted in 43 (33.6%) patients. Granulation tissue on 8th day of treatment noted in 98 (76.6%) cases. Microscopically, on day 8 of treatment, inflammatory-regenerative cytograms were detected in 104 (81.3%) patients. Over the course of 16 days, wounds decreased by 62.1±2.5% in all observations. In 47 (36.7%) cases, secondary sutures were applied, in 30 (23.4%) — grafting. A month later, healing was noted in 106 (82.8%) patients. Complications (wound bleeding) were noted in 7 (5.5%) patients. Reoperations were performed in 11 (8.5%) patients. Period of complete healing was 29.3±0.4 days.Conclusions: vacuum therapy is an effective way to treat wounds in purulent surgery. Time of complete reparative regeneration of wound and period of expensive inpatient treatment are reduced.