Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS, et al.
American journal of clinical dermatology. Date of publication 2005 Jan 1;volume 6(3):185-94.
1. Am J Clin Dermatol. 2005;6(3):185-94.
Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device:
a review.
Venturi ML(1), Attinger CE, Mesbahi AN, Hess CL, Graw KS.
Author information:
(1)Georgetown University Medical Center, Washington, USA.
The use of sub-atmospheric pressure dressings, available commercially as the
vacuum-assisted closure (VAC) device, has been shown to be an effective way to
accelerate healing of various wounds. The optimal sub-atmospheric pressure for
wound healing appears to be approximately 125 mm Hg utilizing an alternating
pressure cycle of 5 minutes of suction followed by 2 minutes off suction. Animal
studies have demonstrated that this technique optimizes blood flow, decreases
local tissue edema, and removes excessive fluid from the wound bed. These
physiologic changes facilitate the removal of bacteria from the wound.
Additionally, the cyclical application of sub-atmospheric pressure alters the
cytoskeleton of the cells in the wound bed, triggering a cascade of intracellular
signals that increases the rate of cell division and subsequent formation of
granulation tissue. The combination of these mechanisms makes the VAC device an
extremely versatile tool in the armamentarium of wound healing. This is evident
in the VAC device's wide range of clinical applications, including treatment of
infected surgical wounds, traumatic wounds, pressure ulcers, wounds with exposed
bone and hardware, diabetic foot ulcers, and venous stasis ulcers. VAC has also
proven useful in reconstruction of wounds by allowing elective planning of the
definitive reconstructive surgery without jeopardizing the wound or outcome.
Furthermore, VAC has significantly increased the skin graft success rate when
used as a bolster over the freshly skin-grafted wound. VAC is generally well
tolerated and, with few contraindications or complications, is fast becoming a
mainstay of current wound care.
PMID: 15943495 [Indexed for MEDLINE]
