Vacuum-assisted closure: indications and clinical experience

The use of subatmospheric pressure to promote wound healing has gradually found support in the past few years. The vacuum-assisted closure system uses a pump providing a continuous negative pressure of preferably 125 mmHg, which is distributed over the wound surface by an airtight covered foam. The exact mechanisms of vacuum therapy are not yet understood, but clinically soft tissue defects seem to heal faster when subatmospheric pressure is applied. Our experience with the first 100 patients with soft tissue defects of different origin that were treated with vacuum therapy is presented. In 29 patients, the wounds healed without further surgical intervention, 53 patients underwent secondary wound closure and 11 patients required more than one procedure. Seven patients died due to their underlying disease. Few complications were seen. Vacuum sealing is a new therapeutic concept in wound healing which can precede and sometimes replace surgical wound closure.