Vacuum-Assisted Wound Closure for Cheaper and More Comfortable Healing of Pressure Sores: A Prospective Study

Abstract

Pressure sores are a common complication of patients with spinal injuries. The vacuum-assisted closure technique is widely used to induce and promote wound healing. We tested our clinical impression that pressure sores healed faster with vacuum-assisted closure, and compared it with the traditional wet-to-dry/wet-to-wet technique with gauze soaked in Ringer's solution changed three times a day. Consecutive patients with pressure sores were entered into the study. Two randomised groups of 11 patients each with pressure sores of the pelvic region were included. We found no difference in time to reach 50% of the initial wound volume between the two methods. The vacuum-assisted group took a mean (SD) of 27 (10) days and the traditional group 28 (7) days. The two methods were equally effective in forming granulation tissue, so one can profit from the other advantages of the vacuum-assisted treatment (reduced costs and improved comfort) knowing that the effect on the formation of granulation tissue is as good as with the traditional treatment.

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

“…29 In the first study the length and width of an ulcer decreased significantly (p<0.01) in NPWT group compared to standard care group at week 9. 24 In the other two studies the authors did not report a significant difference between the two groups, respectively in Wanner 27 days in NPWT group and 28 in the traditional treatment and 51.8% with NPWT in Ford and 42.1% with traditional treatment 28,29 (Tab. IV) .…”

“…Three trials described the reduction in ulcer volume, but the outcome descriptions were very inconsistent [24,28,29]. Dwivedi reported the length and width of ulcer, 24 differently Wanner reported the mean (SD) time to reach 50% of the initial volume 28 and Ford reported the mean percent reduction in ulcer volume. 29 In the first study the length and width of an ulcer decreased significantly (p<0.01) in NPWT group compared to standard care group at week 9.…”

“…In the macroscopic examination, the presence of the granulation tissue was the most important favorable prognostic sign. The evaluation of this tissue was performed in different modalities: newly-formed granulation tissue and wound contracture (measured the volume instead of the area of the usually undermined wounds) as reported from Wanner [28], the absolute and relative proportion of wound surface granulation tissue as reported from Wild 27 or the conversion of slough into red granulation tissue as reported from Dwivedi. 24 Conversely the presence of exudates, fibrin or necrosis were poor prognostic signs: absolute and relative proportion of fibrin tissue at the wound base or absolute and relative proportion of necrosis.…”

“…II). [24][25][26][27][28][29] Quality assessment of the included studies. Since all the included studies are RCTs the quality assessment was based on the risk of bias.…”

Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures?

“…Subsequently, animal studies [39,41] and additional clinical reports that favored negative pressure wound therapy to reduce edema, decrease bacterial loads, increase granulation tissue formation, and other pathways to promote wound healing [2,38] were published. The majority of studies however, regard chronic or diabetic wounds [5,8,18,42,43,52]. The data regarding chronic and diabetic wounds might be able to be extrapolated to traumatic wounds.…”