Vacuum Assisted Closure
Vacuum assisted closure (also called vacuum therapy) is a sophisticated application of a standard surgical procedure, which is the use of vacuum assisted drainage to remove blood or serious fluid from a wound or operation site. It also can be used in many other applications such as burns, acute and chronic wounds, skin grafts and flaps, dehisced wounds, diabetic and pressure ulcers, and degloving injuries. In was approved by the FDA in 1995 as an application of sub-atmospheric pressure.
The technique is quite simple. A piece of foam with an open-cell structure is introduced into the wound and a wound drain with lateral perforations is laid on top of it. The entire area is then covered with a transparent adhesive membrane, which is firmly secured to the healthy skin around the wound margin. When the exposed end of the drain tube is connected to a vacuum source, fluid is drawn from the wound through the foam into a reservoir for subsequent disposal.
The plastic membrane prevents the entry of air and allows a partial vacuum to form within the wound, reducing its volume and facilitating the removal of fluid. The foam ensures that the entire surface area of the wound is exposed to this negative pressure effect, prevents obstruction by contact with the base or edges of the wound, and eliminates the possibility of tissue necrosis.
V.A.C. does the following: (1) promotes granulation tissue; (2) promotes formation of new blood vessels; (3) increases blood flow to the wound; (4) removes edema; and (5) removes bacterial colonization. Generally speaking, V.A.C. draws wound edges together; removes fluids and infectious materials.
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