Zor kapanan yarar için VAC (Vacuum Assisted Closure ) uygulanması
I have only a limited experience with VAC (Vacuum Assisted Closure,
product of Kinetic Concepts, Inc).It consists of pump that producescontrolled sub-atmospheric pressure and is connected with sterile
polyurethane foam covering the wound. Before application all necrotic
tissues have to be surgically removed. Sub-atmospheric pressure like
vacuum cleaner sucks the exudate, diminish swelling and bacterial count,
and promote vascularisation. It’s very expensive; some cheaper and
simpler systems were published:
Meyer CD, Husler R, Werner CMI. Weight-loaded syringes as a simple and
cheap alternative to pumps for vacuum-enhanced wound healing. Plastic
and Reconstructive Surgery 2005; 115; 2174-2176. (Fig1- 2)
Some examples:
1. Pressure ulcer (fig 3). Debridement-VAC- closed completely after ten
days without further surgery.
2. Fasciitis necrotisans- 26.5.05;before last debridement (fig 4) – VAC
- 7.6.05 (fig 5)
3. Provocative case. After two years of surgical treatment: fracture-
non union- osteomyelitis- skin necrosis, failed flaps and grafts. Note
scarce vascularisation of distal fragment of tibia (fig 6). Treatment
with VAC as last option before amputation (24.3.06 fig 6 and 13.6.06 fig
7).Sincerely,
Krunoslav Margic
Prim. dr. Krunoslav Margic’, dr.med.
Head of department of plastic and reconstructive surgery
General hospital
SI-5290 Sempeter pri Gorici
Slovenija
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