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Vacuum-assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement.
- Source :
- International Wound Journal; Apr2010, Vol. 7 Issue 2, p81-85, 5p, 4 Color Photographs
- Publication Year :
- 2010
-
Abstract
- Patients with massive venous stasis ulcers that have very high bacterial burdens represent some of the most difficult wounds to manage. The vacuum-assisted closure (VAC) device is known to optimise wound bed preparation; however, these patients have too high a bacterial burden for simple VAC application to facilitate this function. We present the application of the VAC with instillation of dilute Dakins solution as a way of bacterial eradication in these patients. Five patients with venous stasis ulcers greater than 200 cm<superscript>2</superscript> that were colonised with greater than 10<superscript>5</superscript> bacteria were treated with the VAC instill for 10 days with 12·5% Dakins solution, instilled for 10 minutes every hour. Two patients had multi-drug-resistant pseudomonas, three with MRSA. All the five had negative quantitative cultures, prior to split thickness skin graft with 100% take and complete healing at 1 year. Adequate delivery of bactericidal agents to the infected tissue can be very difficult, especially while promoting tissue growth. By providing a single delivery system for a bactericidal agent for a short period of time followed by a growth stimulating therapy, the VAC instill provides a unique combination that appears to maximise wound bed preparation. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 17424801
- Volume :
- 7
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- International Wound Journal
- Publication Type :
- Academic Journal
- Accession number :
- 49206214
- Full Text :
- https://doi.org/10.1111/j.1742-481X.2010.00658.x