Chronic, open and non-healing wounds are a great challenge to surgeons and treatment of these wounds can cost a lot and can involve a lot of time. The patient may even have to remain in the hospital for a long duration of time. Wound healing is a complex process and is dynamic. The first step in wound healing is cell migration which is essential for repair and closure.
Other sequences in wound healing are debris removal, infection control, control of inflammation, development of new blood vessels which is known as angiogenesis, deposition of granulation tissue, contraction of the wound, remodelling of the matrix of the connective tissue and maturation. Defects in any of the sequences of wound repair can result in chronic wounds. Such wounds are associated with pressure, venous insufficiency, trauma, diabetes mellitus, prolonged immobilization and vascular disease.
VAC therapy is known to be effective for the treatment of chronic wounds. Rapid healing of wounds also decreases hospitalization stay and cost of treatment. Other benefits include faster return to activity and decreased risk of infection (Joseph et al, 2000). Pressure ulcers VAC therapy is useful in the treatment of full-thickness pressure ulcers. It is recommended both for definitive therapy and also for optimization of wound bed prior to surgical closure.
VAC therapy improves perfusion and promotes granulation tissue formation. Diabetic foot ulcers Chronic diabetic foot ulcers pose a challenge to the physicians (Sibbald, et al. , 2003). Many a times, these ulcers need multi-modality interventions like wound debridement, antibiotic treatment, revascularization and offloading of the foot (Hopf et al, 2001). Many treatments have been reported for diabetic foot in the literature.
These include negative pressure wound therapy, administration of growth factors, electric stimulation, tissue substitutes with either skin grafts or bioengineered tissue and advanced moist wound therapy (Blume et al, 2008). Blume et al (2008) conducted a randomized control trial on the efficacy of VAC therapy and reported that this form of therapy is much superior to other treatment modalities for diabetic foot ulcer. The authors reported that VAC therapy decreased the risk of amputation and increased chances of complete ulcer healing.