Vacuum-Assisted Closure (VAC) is a sophisticated development of a typical surgical procedure that uses vacuum-assisted drainage in order to remove blood or other fluids from the wound or surgical site.
Uses of Vacuum-Assisted Closure
Vacuum-Assisted Closure has been increasingly utilized over the past decade for acute, subacute or chronic wounds. This technique has been expanded to include various types of wounds such as chest, cardiac (heart), and abdominal surgical sites.
The VAC Procedure
Vacuum-assisted closure (also termed vacuum therapy, vacuum sealing or topical negative pressure therapy) is an uncomplicated procedure in which a piece of foam with an open-cell structure is placed directly into the wound, while a wound drain with lateral perforations is laid on top of the foam. The entire wound site is then covered with a transparent, adhesive membrane that is securely attached to the healthy skin surrounding the wound site. While the exposed end of the drain tube is attached to a vacuum source, the fluid from the wound is pulled from the wound through the foam and goes into a reservoir for disposal.
The plastic membrane serves to prevent air from penetrating the wound site, enabling a vacuum to form within the wound, helping facilitate the removal of excess fluid buildup. The foam serves several critical roles in that it ensures that the entire wound has the same amount of negative pressure distributed around it, reducing the possibility of tissue necrosis, and it prevents obstructions of the drain perforations through its contact with the edges of the wound.
How It Works
The use of negative pressure in the VAC draws out edema fluid from the wound through suction. This promotes increased blood flow to the area (though blood vessel dilation) and greater cell proliferation. Removing the fluid buildup helps reduce the risk of infection due to bacterial colonization of the wound. VAC also facilitates the formation of granulation tissue, which is an important factor in wound healing and closure.
Advantages Over Other Treatments
Typically, chronic wounds require lengthy hospital stays in order to receive necessary treatment. VAC gives you the option of shorter hospital stays by enhanced treatment that facilitates a faster healing process, allowing the patient to return to their normal routine quicker. Expedited healing also results in lower levels of pain and discomfort resulting in higher quality of life for the patient. Other treatment options for chronic wounds typically require at least 2 dressing changes a day, requiring specialized skills in order to reduce the risk of infection. VAC is a closed system that only requires changes every 48 hours, lowering the need for material and personnel, reducing wound exposure and lowering the risk of infection.
Who Is A Candidate?
While VAC may be used on almost all wound types, it has seen the highest success rates with deep, chronic wounds.
Wounds that are to be treated with VAC require an aggressive debridement, which is necessary to remove necrotic (dead) tissue in the wound that delays healing and increases the risk of infection.
Length Of Treatment
Treatment duration is dependent on the severity of the wound. Smaller, shallower wounds will not require the longer treatment periods. A study conducted in the United States over a 6 week period found 80-90% would closure was achieved by patients with chronic, non-healing wounds. It was estimated that complete closure would take approximately 16-20 weeks for large, chronic wounds.
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