Suction Therapy Aids Wound Healing - Brief Article

USA Today (Society for the Advancement of Education), Feb, 2000

Utilization of sub-atmospheric pressure therapy (VAC therapy) allows new tissue to form rapidly in lower-extremity wounds with exposed tendon, ligaments, bone, or orthopedic hardware, according to a study by Anthony DeFranzo, associate professor of surgery, Wake Forest (N.C.) University School of Medicine. "The bacteria counts in the wound also drop dramatically as the vacuum is increased." In VAC therapy, a sterile foam dressing is placed over the wound and covered with an adhesive sheet. Suction tubes placed in the foam remove air from the dressing, creating an enclosed area in which the air pressure is less than normal. The suction draws the edges of healthy tissue around the wound together and promotes formation of new tissue. This procedure is especially beneficial for patients who may be poor candidates or ineligible for surgery because of complicating factors.

"The suction created by the VAC therapy actually pulls the sides of the wound together and stimulates new healing tissue," DeFranzo explains. "The bacteria counts in the wound also drop dramatically as the vacuum is increased."

The study included 75 patients who had open wounds of the lower extremities, many the result of trauma such as gunshots. Granulation tissue--new tissue that contains many capillaries surrounded by fibrous collagen--rapidly formed inside the wound, covering bone and hardware. After initial coverage was established, the wound was closed with a skin graft or a small amount of muscle tissue, both relatively simple surgical procedures. None of the patients required a free-flap procedure--microsurgery in which tissue containing blood vessels is transplanted in the wound. A small number of the patients experienced complications, with four requiring additional surgery and one with a severe gunshot wound requiring amputation.

By removing excess fluid, the system decreases the circumference of the wound and reduces its surface area. In some patients, the therapy can be used to close the entire wound without the use of a skin graft or muscle flap. This technique is especially helpful in preparing debilitated patients for surgery, for healing patients who have failed free or muscle flaps, or to close the wound completely in patients who are not candidates for surgery.