Functional Outcomes in Orthopaedic Open Wounds Treated With Vacuum-Assisted Closure Therapy: A Prospective Case Series.

Open fractures with extensive soft-tissue damage, significant periosteal stripping, and exposed bone ends pose a significant challenge in orthopaedics. So, we conducted a prospective study that investigated the efficacy of vacuum-assisted closure (VAC) therapy in improving functional outcomes for orthopaedic open wounds. A prospective case series was conducted for a period of 18 months at the department of orthopaedics. Seventeen patients with open wounds were included in the study after fulfilling specific criteria. The study involved 17 patients with open wounds, where VAC therapy was applied within 24 hours of admission for 14 patients, and for three patients with superficial infection, thorough wound debridement preceded VAC dressing. Follow-up with patients continued until definitive skin cover procedures were performed. The majority of cases were attributed to open compound fractures caused by road traffic accidents (82.35%), followed by train traffic accidents (11.76%) and accidental falls (5.88%). The leg (47%) was the most common location of injury, followed by the forearm (23.52%). The average treatment duration was 10.5 days, with an average of 3.3 dressing changes, indicating the efficacy and feasibility of VAC therapy in clinical practice. The average wound size reduction at completion was 15mm, and 15 out of 17 patients achieved successful wound healing. The average time required for forming a uniform granulation bed was 10.5 days, highlighting the efficiency of VAC therapy in promoting tissue regeneration. Our study findings revealed that there is a significant reduction in the rate of wound infection with the application of VAC therapy, along with a shorter duration for the formation of healthy granulation tissue, rendering the wound suitable for definitive skin cover procedures such as split skin graft and flap cover at an accelerated rate. Additionally, technical challenges associated with applying VAC dressing in the presence of an external fixator were successfully managed through realignment strategies, further underscoring the adaptability and efficacy of VAC therapy in addressing complex wound scenarios. Copyright © 2024, Gottipati et al.

Citation

Sunil Gottipati, Bandi Gowtham, Sindhu Chalimeda, Shivani Ravipati, Vishaal P, Kaarvi Khullar. Functional Outcomes in Orthopaedic Open Wounds Treated With Vacuum-Assisted Closure Therapy: A Prospective Case Series. Cureus. 2024 Feb;16(2):e54468

PMID: 38510913

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