Retrospective Study Of Vacuum Assisted Closure For The Treatment Of Acute And Chronic Wounds

Objective:Vacuum assisted closure(VAC)was first proposed by Argenta and Morykash in1997 and was initially used as an adjunctive treatment for complex wounds.After many clinical applications and explorations,it has been widely used in the treatment of various acute and chronic wounds,and has achieved significant results.This study mainly reviewed the data of all types of acute and chronic wounds treated with VAC technology in our department and discussed the effects of VAC on acute and chronic wound healing.Methods:To collect 50 cases of third degree burn wounds,50 cases of acute infection wounds,44 cases of stress wounds and 44 cases of diabetic foot wounds from the Burn Department of the First Affiliated Hospital of Nanchang University from June2015 to December 2017 clinical information.According to whether or not VAC technology was applied during the treatment,they were divided into treatment group and control group.25 cases were included in the acute infection wound treatment group and control group;25 cases were in the third-degree burn wound treatment group and the control group;pressure wound and diabetic foot wound treatment The group and the control group were 22 cases respectively.All patients were admitted to the hospital to improve routine examinations,and wound secretions and necrotic tissue were taken from the patients for bacterial culture;wounds were cleaned,and conventional traditional dressing treatments were performed.The patients in the treatment group were treated with VAC technique after one debridement operation,and the control group was treated with traditional dressings;after both groups reached the second-stage surgery,they were required to undergo surgical repair(including flap metastasis,skin grafting or direct suture)..Record the time from the first operation to the wound healing,the wound culture results and the number of dressings;the preoperative blood analysis,bloodbiochemical results(white blood cell count,red blood cell count,hemoglobin content,neutrophils count,neutrophil ratio,glutamate aminotransferase,aspartate aminotransferase,creatinine,urea nitrogen,albumin);postoperative blood analysis,blood biochemical results,hospital stay,overall hospitalization costs and so on to make statistical analysis.Results:The time required for wound healing in the VAC treatment group from the first operation to the wound was 13.6±3.5 days,and that in the control group was20.5±5.15 days;the first operation of the third-degree burn wound group was performed until the wound was healed.The time was 22.9±6.95 days,and the time required for the control group was 33.7±8.15 days;the time from the first operation to the healing time of the pressure wound wound treatment group was 25.71±8.68 days,and the time required for the control group was 36.95±7.54 days.Diabetic foot wound treatment group to the second phase of the operation time was 24.38±6.96 days,the control group required time was 35.72±8.49 days;statistical analysis showed that the P values of the four groups of data were less than 0.01,with significant statistics significance.After the first surgical treatment,wound secretions from patients were taken for bacterial culture.Twenty-four patients in the VAC treatment group of the third-degree burn wounds were negative(wound culture was sterile)and one was positive(cultured bacterial growth);in the control group,25 were negative and 7 were positive.Of the 25 patients in the acute wound VAC group,22 were negative and 3were positive;in the control group,16 were negative and 9 were positive.In the pressure wound VAC treatment group,20 of 22 patients were negative and 2 were positive;in the control group,16 were negative and 6 were positive.Of the 22 patients with diabetic foot wound VAC,20 were negative and 2 were positive.In the control group,17 were negative and 5 were positive.The positive rate between the treatment group and the control group was tested by X2 and P<0.05 was obtained,which was statistically significant.The preoperative and postoperative blood analysis and blood biochemical resultsshowed that the white blood cell count,neutrophil count,and neutrophils in the treatment group decreased more rapidly than before and after the control group,and were statistically significant after t-test(P<0.05).The preoperative and postoperative values of protein content were also significantly lower than those in the control group.The t test showed that P<0.05 was statistically significant.There was no significant difference in the difference between the two groups before and after the data(P>0.05),and there was no significant correlation.The number of dressing changes,days of hospitalization,and hospitalization costs in the treatment group were significantly less than those in the control group.The recurrence rate in the chronic wound group was significantly lower than that in the control group after six months of follow-up.The data between the treatment group and the control group was statistically analyzed and a P< 0.05,indicating statistical significance.Conclusion:Compared with traditional surgery and debridement and dressing changing methods,VAC technology not only can effectively shorten hospital stay,control infections,and reduce hospitalization costs,but also can reduce the frequency of dressing changes and effectively reduce the workload of medical personnel,which is a better repair.Treatment of acute and chronic wounds.