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Indian Journal of Orthopaedics Surgery


Vacuum assisted closure therapy versus standard wound therapy for compound fractures


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Author Details: Utkal Gupta, V.P Pathania, Sanjay Gupta, Apser Khan, Sirpuneet Singh

Volume : 3

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 147

Article End Page : 152


Abstract

Introduction: Compound fractures are surgical emergencies which require both skeletal stability as well as adequate soft tissue coverage. Debridement of all the dead and necrotic tissue can result to large soft tissue defects. Vacuum assisted closure therapy is a newer modality which can overcome all these problems and accelerates wound healing when applied to open wounds.
Aim and Objectives: To analyse and compare the results of vacuum assisted closure therapy and standard wound therapy in management of compound fractures.
Materials and Methods: 30 patients having compound fractures upto grade IIIB (Gustilo and Anderson classification) were randomly treated either using SWT or VAC therapy between November 2014 to June 2016. There were 15 patients in each group. After initial wound debridement and provisional fracture fixation, therapy was started and continued till the wound got optimized for coverage either by split skin graft or flap.
Results: The mean time taken by wound to get optimized for coverage in the VAC therapy group was 10.13 ± 2.55 days whereas in SWT group was 11.20±1.65 days. The mean rate of decrease in size of wound by VAC therapy was 1.5453 ± 0.5855% whereas by SWT was 1.0587 ± 0.3637%. Infection was seen in 02 patients in the VAC group and in 05 patients in the SWT group.
Conclusion: VAC therapy is superior to SWT in terms of rate of decrease in size of wound, lesser infection rate and shorter time for wound to get optimized for coverage.

Keywords:
Compound Fracture, VAC (Vacuum assisted closure), SWT (Standard wound therapy), Flap, Split Skin Graft