Negative pressure therapy - vacuum

Abstract

Treatment of complex wounds is still a challenge for the Medicine; it constitutes a burden for the patients, professionals and healthcare providers. The development of a wound followed by a onerous treatment increases the hospitalization time, raises the overall cost and increases morbid-mortality rates. The negative pressure method applied to the wound bed through a poliuretane foam, popularized nowadays as “the vacuum method” was introduced by Argenta and colleagues 15 years ago. Its success in reducing the time of wound preparation was attributed to the reduction of edema, reduction of the bacterial colonies counting and increasing of local blood flow with corresponding better granulation tissue. Many studies have been done since then in order to better clarify the mechanism of action of vacuum in the wound. Evaluation of this method was started by us at the Division of Plastic Surgery, “Hospital das Clínicas - FMUSP” in 2001. Initially it was used in chronic complex wounds as diabetic, venous and pressure sores, lesions that do not heal due to lack of good healthy granulating tissue at the wound bed, preventing also the take of skin grafts. In our experience the time for wound bed preparation was much shortened than with conventional therapies allowing earlier skin grafting and definite closure. Our results pointed out also for new indications for the use of negative pressure as in acute traumatic cases, particularly in lower extremities, in complicated surgical cases like in thoracic and abdominal complications and over the skin graft to enhance better take of grafting procedure