Sistema de cierre asistido por vacío en heridas complejas. Estudio retrospectivo

Introduction: Vacuum-assisted closure (VAC) therapy is a dynamic and non-invasive system for improving wound healing. This novel therapy is based on applying air suction at a controlled sub-atmospheric pressure. The most important benefits of this therapy include, a reduction in the wound area together with induction of new granulation tissue formation, effective wound cleansing (removal of small tissue by suction), and the continuous removal of wound exudate.The aim of this study was to describe our experience with VAC therapy for complex wounds. Material and method: We retrospectively evaluated our experience with VAC therapy between April 2007 and August 2008. We employed a "suprafascial" VAC system and an open abdomen VAC system. Descriptive statistical techniques were applied and percentages and means were calculated. Results: VAC therapy was applied in 20 patients, of whom 16(80%) had abdominal complex wounds, and 4(20%) in other locations. We employed a "suprafascial" VAC system in 17 patients (85%) and an "intra-abdominal" VAC system in 3 patients (15%). Two patients (10%) developed fistula during "intra-abdominal" VAC therapy (urinary and enteric) but the closure was achieved before therapy was finished. Mean hospital stay was 38.3 days (7-136). No mortality was directly due to the VAC system. Two patients (10%) died due to their septic condition and the rest are still alive. Mean therapy length was 29.17 days (1-77) in the "suprafascial" group and 18 days (7-49) in the "intra-abdominal" group. Average costs were 3197.97 (119.1-10780.25) per patient. Conclusions: VAC therapy can improve and accelerate abdominal wound healing also in the presence of infection and bowel fistula.