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A wound VAC or Vacuum Assisted Closure is a gadget that allows individuals to perform Negative Pressure Wound Therapy or NPWT. The device comprises of a dressing that is attached to a tube and fitted to the wound VAC. Negative pressure wound therapy is generally used with prolonged cases of wounds that do not heal with the use of traditional healing methods. Wound VAC may also be used in cases of surgical wounds that have reopened. Individuals who wish to employ wound VAC therapy do not have to be hospitalized, though the general supervision of a nurse is required.

Wound VAC can be considered as a therapeutic technique that involves the use of vacuum dressing to facilitate the healing of chronic and acute wounds and also to promote the effective healing of first or second degree burns. Wound VAC involves the controlled use of sub-atmospheric pressure to the wound sites. This is conducted via a sealed wound dressing that is hooked up to a vacuum pump. As the knowledge of this therapy spread, its application increased consistently over the 1900s and 2000s. Several studies relating to Wound VAC and negative pressure wound therapy have been performed and subsequently published. Wound VAC is known to be very helpful for treating diabetic ulcers, but its use in treating other wound types is under scrutiny.

The Wound VAC technique

Wound VAC therapy can be performed in the following ways:

  • The outlines of a wound are fitted with a dressing and then a transparent film is used to seal it.
  • A drainage tube is then fixed to the dressing using an opening that is present in the transparent film.
  • This drainage tube is also fixed to a vacuum supply source, which turns the open wound into a closed and controlled one, during the process of eradicating the excess liquids from the wound surface. The fluids are thus easily removed and the circulation is enhanced. A moist healing situation is thus created which reduces the risk to edema.

Wound VAC therapy is generally advised for the treatment of wounds that are chronic in nature or those which pose several difficulties during treatment with traditional methods. Wounds that accompany diabetes are relevant examples.

There are many commercial products that use the wound VAC technique. Based on the type of dressing that is used over the wound bed, such products can be separated into three categories:

  • Open-cell foam
  • Gauze
  • Honeycombed textiles with a wound contact bed that is dimpled

Open-cell foam:

  • Foam dressings are employed to fill wounds with open cavities. They can be cut as per the size of the wound. The wound is filled by applying the foam dressing which is then followed by the application of a film drape on the top to completely seal the dressing. An opening in the film drape provides the route for a vacuum tube connection. This vacuum tube is fixed to a canister that is present besides a vacuum pump.

Gauze:

  • A wound VAC dressing may also be performed by using standard medical equipment like a flat drain, a transparent film, an open weave cotton gauze and tubing that is fixed to a vacuum pump. The flat drain is placed between gauzes, which is then applied on the wound. A complete seal is created with a film drape that is used to cover the wound. The drain is then connected to the vacuum pump with the help of the tubing.

Honeycombed textiles with a wound contact bed that is dimpled:

  • This type of dressing consists of sheets of non-woven polyester that are bonded by a silicone elastomer. It comes with a non-sticky wound contact surface which is made up of several tiny semi-rigid structures in the shape of a dome.

In all the above wound VAC techniques, the vacuum pump can be programmed to deliver intermittent or continuous pressure after the sealing of the dressing. Depending on the gadget used, the pressure levels may vary between -125 mmHg to −75 mmHg. Such pressure also depends on the patient tolerance as well as the type of material that is used. The application of pressure can be intermittent or constant.

The type of dressing that is used depends on a number of variables such as the patient’s condition, the clinical objectives and the type of wound.

  • Gauze may be used in cases of wounds with depressed or explored tunnels or tracts; and pain sensitive individuals with irregular or shallow wounds.
  • Foam may be used in cases where the wound has regular outlines as it facilitates the easy cutting of the dressing to fit the wound. It can also be used if the objective is wound contraction and aggressive granulation formation.

The effectiveness of wound VAC therapy

As per 2007 Cochrane Review, wound VAC therapy was imperfect and entailed more study as compared to other forms of alternative care. However, the study did accept that wound VAC supported improved healing of wounds.

As per the 2010 systematic review, wound VAC was found to be effective in treating diabetic feet ulcers, though results for ‘mixed wounds’ and ‘bedsores’ were found to be wanting. The study also concluded that wound VAC is safe to use and does not cause any complications.

Wound vac pictures

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