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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2007 August;31(2):53-9
Treatment of substance loss of foot soft tissue by means of Vacuum Assisted Closure therapy: clinical experience
Bruschi S., Bocchiotti M. A., Boriani F., Bellezza E., Fraccalvieri M.
Istituto di Chirurgia Plastica Università degli Studi di Torino, Torino
Aim. Acute and chronic wounds of the foot often present challenging features. Vacuum Assisted Closure (VAC Therapy System®, KCI USA, San Antonio, TX, USA) is a method for treatment of skin lesions utilizing a negative pressure applied within the wound. This negative pressure wound therapy promotes granulation and reduces the time necessary for wound healing. Authors intend to describe their experience in the use of this device for the treatment of defect of foot soft tissues.
Methods. At the Plastic Surgery Department of Turin University from March 2000 to December 2006 38 patients with defects of foot soft tissues were treated with negative pressure wound therapy (19 diabetic feet of which 8 were post-amputation stumps, 7 vascular ulcers, 9 post-traumatic defects and 3 patients with partially necrotic flaps). Wound was localized on the dorsum in 13 cases, on the malleoli in 12 cases, distal plantar region was involved in 8 cases and heel or proximal plantar region in 5 patients. Among patients, whose age ranged between 28 and 89 years, 25 were males and 13 females.
Results. In 22 of the patients treated (58%) VAC® therapy brought to a significant improvement of local condition, which allowed, in some cases, a wound healing by secondary intention. In most cases, however, said device helped prepare an adequate wound bed for a surgical reconstruction, mainly through skin graft. In the remaining 16 cases wound healing was not obtained or improvements achieved were not so relevant that a coverage could be possible, within a month’s therapy.
Conclusion. VAC® therapy has been proven as a very versatile device, which allows or eases healing of many complex wounds of the foot. Various are the mechanisms of actions by which VAC® helps wound repair. In applying this therapy, generally safe, indications, contraindications and precautions have to be taken into account as well as the site-specific applicability in the various anatomic-functional regions of the foot. The negative pressure wound therapy applied through VAC® system represents a safe and valid treatment for complex wounds of the foot.