Role of vacuum assisted closure therapy in chronic wounds: for some cases in Navi Mumbai

Shitiz Gupta, Shikha Gupta, Tanveer Parvez Shaikh, Jatin B. Wani, Ajay Gujar, Abhijit Bagul, Raj Gautam, Nandkishor Narwade, Sonia Miglani


Background: This study was performed to evaluate the results of vacuum assisted wound therapy in patients with chronic non healing ulcer.

Methods: The study was conducted in the department of General Surgery at a tertiary care hospital. It was an observational study with prospective design. The role of NPWT in various wounds was studied in 10 patients.

Results: Out of 10 wounds taken in the study, 7 wounds  reduced  in  area  & were  resurfaced with Split thickness skin  grafting and 3 wounds  showed  reduction in area & were subjected to secondary closure.

Conclusions: Vacuum assisted closure (VAC) therapy provides sterile and controlled environment to large, exudating wound  surfaces and is  treatment  of  choice  in  infected / non – healing wounds,  not  responding  to  standard  treatment.


VAC Therapy, Chronic non healing ulcer, Ulcer, NPWT

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Joseph E, Hamori CA, Bergman S, Roaf E, Swann NF, Anastasi GW. A prospective randomized trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds, Wounds. 2000;12(3):60-7.

Yaremchuk MJ, Burgess AR, Brumback RJ. Concepts in soft tissue management, in Lower Extremity Salvage and Reconstruction. Orthopaedic and Plastic Surgical Management, Eds. Elsevier Science, New York, NY, USA. 1989:95-106.

Haller JA, Billingham RE. Studies of the origin of the vasculature in free skin grafts, Annals of Surgery. 1967;166(6):896–901.

Geishauser M, Staudenmaier RW, Biemer E. Donor-site morbidity of the segmental rectus abdominis muscle flap. British Journal of Plastic Surgery. 1998;51(8):603–7.

Kelly M, Searle A. Improving the donor site cosmesis of the latissimus dorsi flap. Annals of Plastic Surgery. 1998;41(6):629–32.

Heng MCY. Topical hyperbaric therapy for problem skin wounds. Journal of Dermatologic Surgery and Oncology. 1993;19(8):784–93.

Morykwas MJ, Argenta LC. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Annals of Plastic Surgery. 1997;38(6):563–77.

Clarke RAF, Henson PM. The Molecular and Cellular Biology of Wound Repair. Plenum Press, New York, NY, USA. 1988;1;3-50.

Cohen IK, Diegelmann RF, Lindblad WJ. Wound Healing: Biochemical and Clinical Aspects, WB Saunders, Philadelphia, Pa, USA. 1992;31(90):926.

Hunt TK. Vascular factors govern healing in chronic wounds. In Clinical and Experimental Approach to Dermal and Epidermal Repair: Normal and Chronic Wounds, A. Barbul, M. D. Caldwell, W. H. Eaglstein et al., Eds. Wiley & Leiss, New York, NY, USA. 1991;1-17:365.

Pierce GF, Vande Berg J, Rudolph R, Tarpley J, Mustoe TA. Platelet-derived growth factor-BB and transforming growth factor beta1 selectively modulate glycosaminoglycans, collagen, and myofibroblasts in excisional wounds. American Journal of Pathology. 1991;138(3):629–46.

Laiho M Keski OJ. Growth factors in the regulation of pericellular proteolysis: a review. Cancer Research. 1989;49(10):2533–53.

Whitby, David J, Ferguson MWJ. Immunohistochemical studies in fetal and adult wound healing. Fetal Wound Healing. New York: Elsevier. 1992:161-76.

Hunt TK. The physiology of wound healing. Annals of Emergency Medicine. 1988;17(12):1265–73.

Kucan JO, Robson MO, Heggers JP. Comparison of silver sulfadiazine, povidone-iodine and physiologic saline in the treatment of chronic pressure ulcers. Journal of the American Geriatrics Society. 1981;29(5):232–5.

Seiler WO, Stahelin HB, Sonabend W. Einflus aerobe und anaerober keime auf den heilungsverlauf von dekubitalulzera. Schweizerische Medizinische Wochenschrift. 1979;109:1595–9.

Daltrey DC, Rhodes B, Chattwood JG. Investigation into the microbial flora of healing and non-healing decubitus ulcers. Journal of Clinical Pathology. 1981;34(7):701–5.

Ryan TJ. Microcirculation in psoriasis: blood vessels, lymphatics and tissue fluid. Pharmacology and Therapeutics. 1980;10(1):27–64.

Banwell P, Withey S, Holten I. The use of negative pressure to promote healing. British Journal of Plastic Surgery. 1998;51(1):79–82.

Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Annals of Plastic Surgery. 1997;38(6):553–562.

Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Annals of Plastic Surgery. 2004;52(3):276–80.

Thoma R. Ueber die histomechanik des gefasssystems und die pathogens der angioskeleroose. Virchows Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin. 1911;204(1):1–74.

Philbeck TE, Whittington KT, Millsap MH, Briones RB, Wight DG, Schroeder WJ. The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare Medicare patients,” Ostomy/Wound Management. 1999;45(11):41–50.

Ilizarov GA. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clinical Orthopaedics and Related Research. 1989;238:249–81.

Hall GD, Van Way CW, Fei' Tau Kung FTK, Compton-Allen M. Peripheral nerve elongation with tissue expansion techniques. Journal of Trauma. 1993;34(3):401–5.

Alvarez OM, Mertz PM, Eaglstein WH. The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds. Journal of Surgical Research. 1983;35(2):142–8.

Akin Yoola AL, Ako-Nai AK, Dosumu O, Aboderin AO, Kassim OO. Microbial isolates in early swabs of open musculoskeletal injuries. The Nigerian Postgraduate Medical Journal. 2006;13(3):176–81.

Fleischmann W, Strecker W, Bombelli M, Kinzl L. Vacuum sealing for treatment of soft tissue injury in open fractures. Unfallchirurg. 1993;96(9):488–92.

Jones SM, Banwell PE, Shakespeare PG. Advances in wound healing: topical negative pressure therapy. Postgraduate Medical Journal. 2005;81(956):353–7.

Sinha K, Chauhan VD, Maheshwari R, Chauhan N, Rajan M, Agrawal A. Vacuum Assisted Closure Therapy versus Standard Wound Therapy for Open Musculoskeletal Injuries. Advances in Orthopedics 2013;245940:8.