Vacuum-assisted healing of various-aetiology wounds: A systematic review

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.

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Local negative pressure technique in abdominal surgery: advantages, disadvantages, controversial issues

Sazonov,

Romashchenko,

Makarov

et al. 2023

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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A literature review of studies on the use of local negative pressure technique (vacuum therapy) in abdominal surgery is presented. The article highlights modern approaches to its use in emergency pathology of the abdominal cavity and retroperitoneal space. The mechanisms of action, advantages and disadvantages of the local negative pressure technique, as well as the main morphofunctional aspects of its application are discussed in detail. Data from recent clinical studies and meta-analyses are summarized, and the effectiveness of using vacuum-assisted laparostomy within the framework of the «damage control» concept in multi-stage surgical treatment of injuries and urgent abdominal diseases accompanied by abdominal sepsis is demonstrated. The use of local negative pressure techniques can reduce postoperative mortality, as well as shorten the length of hospital treatment of patients. However, despite the obvious positive effect on the course of the wound process, vacuum therapy carries the risk of developing serious complications, the most dangerous of which are bleeding and perforation of hollow organs. In addition, it requires very expensive equipment and consumables, as well as training of medical personnel. Thus, the use of vacuum therapy requires a sound approach and a clear understanding of the technical features of its implementation. However, the indications for the use of local negative pressure in abdominal surgery have not yet been clarified, which undoubtedly hinders the wider introduction of this promising technique into clinical practice.

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Vacuum-assisted healing of various-aetiology wounds: A systematic review

Cited by 4 publications

References 56 publications

Application of aldehyde solutions of weak concentrations in complex therapy of infected wounds of extremities

Application of aldehyde solutions of weak concentrations in complex therapy of infected wounds of extremities

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

Local negative pressure technique in abdominal surgery: advantages, disadvantages, controversial issues

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