A Study of Vacuum Assisted Closure in Chronic Non Healing Ulcers

INTRODUCTION: Non-healing ulcers are a major burden in developing countries. Conventional dressings and vacuum assisted closures are the mainstay of treatment. Diabetes mellitus is a major factor that causes a further 8-9% increase in morbidity/ delay in wound healing. AIM OF STUDY: 1. To study the advantage of vacuum assisted closure over conventional dressing in the management of chronic non healing ulcers. 2. To study the difference in rate of amputation, hospital stays in case and control group MATERIALS AND METHODS: Design: Experimental study. Setting: Study is conducted at Government Kilpauk medical college, Chennai which is a tertiary care centre. Patients are selected from general surgery wards Period of Study: 6 months extending from March 2018 to September 2018. Sample Size: 50. Cases are selected from the General surgery wards of Govt. Royapettah Hospital, KMC. Cases and controls are selected from the same wards at different time period. Total 25 cases and 25 controls, they were randomized by the admission. After debridement of the wound, VAC dressing is applied after the bleeding gets stopped. Pre VAC and post VAC C & S is taken. Dressing is given for 72 hours and intermittent suction is given for ten minutes every 12 hours and the negative pressure is applied intermittently and through ROMOVAC Drain, the negative pressure between 100-125 mm Hg. CONCLUSION: V.A.C dressing reduces Hospital stay, improve pus culture sterility, improves outcome by decreasing the number of amputations and increases the number of patients undergoing skin grafting. Also, V.A.C dressing has better outcome in patients with Normal Doppler and good outcome in patients with non active osteomyelitis