Negative pressure wound therapy in open fracture management

Vacuum-assisted closure wound therapy (VAC) has been used as a tool to bridge the period between debridement and definite surgical closure in full thickness wounds. We performed an interventional study (quasi-experimental design) to compare the efficacy of VAC therapy with low cost (locally made) Negative Pressure Wound Therapy (NPWT to conventional moist wound dressing (MWD) therapy in this stage of wound treatment.Methods: Treatment efficacy was assessed by semi-quantitative scoring of the wound conditions and by wound surface area measurements. Complications encountered during therapy and postoperatively hospital stay was recorded.Results: Sixty wounds were included (vacuum n=30, conventional n=30). With vacuum therapy healthier wound conditions were observed. Furthermore, a tendency towards a shorter duration of therapy was found, which was most prominent in late-treated wounds. In addition, the wound surface area reduced significantly faster with vacuum therapy. Surprisingly, these results were obtained without a decrease in the number of bacteria colonizing the wound.