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A Journal on Angiology
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
International Angiology 2009 February;28(1):26-31
Vacuum assisted wound closure in patients with lower extremity arterial disease. The experience from two tertiary referral-centres
Nordmyr J. 1,2, Svensson S. 3, Björck M. 1, Acosta S. 3
1 Institution of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden
2 Department of Surgery, Norrköping County Hospital, Norrköping, Sweden
3 Vascular Centre, Malmö University Hospital, Malmö, Sweden
Aim. The purpose of this investigation was to analyze predictors for wound healing, amputation and mortality after vacuum assisted closure (VAC®) therapy of wounds in the lower limb in patients with arterial disease.
Methods. One hundred and twenty one wounds were treated and followed for 12 months at two vascular centres in Uppsala and Malmö, Sweden. VAC® therapy was applied in the wound at a topical negative pressure of 125 mmHg.
Results. Median age of the patients was 74 years and critical lower limb ischemia was present in 87% of the patients at admission. Intestinal flora was cultivated in 74% of the wounds. VAC® associated bleeding occurred in four patients. Complete wound healing was achieved in 66%. Deep groin infections were associated with synthetic graft infection (P<0.001), treatment outside hospital (P<0.001), faster healing (P<0.01) and lower amputation rate (P<0.005). Diabetes mellitus (OR 2.7; [95% CI 1.2-6.2]) and foot wound (OR 3.0; [95% CI 1.2-7.4]) were independent predictors for amputation. The absence of complete wound healing was the strongest factor for both amputation (P<0.001) and death (P<0.001).
Conclusion. VAC® therapy of complex wounds in the lower limbs in patients with vascular disease was associated with high healing rates. Non-healed wounds after VAC® therapy were predictors for amputation and death.