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Journal of the Korean Wound Management Society 2009;5(1): 50-56. |
| 난치성 압박궤양에서 VAC (Vacuum Assisted Closure)를 이용한 창상 치료 |
| 최의철ㆍ박은수ㆍ김용배 |
| 순천향대학교 의과대학 성형외과학교실 |
| The Treatment of Intractable Pressure Sores Using VAC (Vacuum Assisted Closure) |
| Eui Chul Choi, Eun Soo Park, Yong Bae Kim |
| Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Bucheon, Korea |
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Published online: 30 May 2009. |
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| ABSTRACT |
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Despite numerous advances, non healing wounds continue to be a treatment challenge. The VAC (Vacuum Assisted Closure) has been reported to speed up the healing of various chronic wound by removal of chronic edema, increasing localized blood flow. So we applied the VAC for treatment of the intractable pressure sores with infection, non healthy granulation tissue, systemic factor that could impair wound healing. We applied the VAC in 12 patients with grade III-IV intractable pressure sore whose wound failed conservative management over 6 weeks. Patients associated with generalized rigidity, diabetes mellitus, cardiovacular disease. After infection disappeared, sore size decreased, sore bed appeared with heathy granulation, we reconstructed the pressure sore with skin graft or flap surgery regard to the general condition of patients. All patients responded to the VAC in a week. The VAC facilitated granulation tissue production and the eradication of any pre-existing infection in an average of 35.8 days. Wound closure by granulation, secondary closure, split thickness skin grafting, or local flap achieved. In multiple pressure sores were healed by successively with methods as above. The musculocutaneous flap was used in case requiring cushion like effect at sacral, ischial prominent portions. The VAC used intractable pressure sore decreased wound size, accelerate granualtion tissue formation, do a wound closure with less invasive operation method, make less hospitalization time. there fore it is cost effect. Our results demonstrate the usefulness of the VAC as an adjunct in management of intractable pressure sore with bad general conditions. (J Korean Wound Management Soc 2009;5:50-56) |
| Key Words:
Intractable pressure sores, Vacuum assisted closure |
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