Vacuum Assisted Closure (VAC, Kinetic Concepts Inc) involves application of negative pressure to assist in closure of wounds. There are indications and contraindications to its use.
Indications for use of negative pressure wound therapy
(1) acute surgical wounds
(2) acute traumatic wounds
(2) surgical skin grafts and flaps
(4) dehisced surgical wounds
(5) chronic wounds
(6) diabetic foot ulcers
(7) pressure ulcers
(8) partial thickness burns
(9) treated osteomyelitis
Contraindications for negative pressure wound therapy:
Management That May Allow VAC Therapy
cancer involvement of the wound
untreated osteomyelitis
Treat the osteomyelitis.
necrotic tissue with eschar
Debride the necrotic tissue..
exposed blood vessels, nerves and/or organs
Cover exposed structures with natural tissue or several layers of fine-meshed nonadherent synthetic material
non-enteric fistula that has not been explored
Explore the fistula.
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