Abstract :
Introduction: Despite numerous advances, compound fractures of long bones continues to be a challenge for the treating surgeon. Standard wound dressing required prolonged period, repeated debridement, trauma to granulation tissue and had poor patient compliance. Vacuum-assisted closure provides an extremely efficacious method for treating difficult wounds. This research aimed to study whether VAC gives better outcome in open fractures after primary intervention, whether it leads to faster and more effective wound healing and whether it leads to shorter length of stay in hospital.
Materials and Methods: An interventional study was conducted, studying 30 cases of open tibia fractures who were fitting in the inclusion criteria. It followed Gustillo- Anderson classification to classify cases and then mapped out various conclusions on the aim of study whilst also charting the effect of the treatment in different circumstances, demographics and like.
Result: Amongst the 30 cases studied,all patients were evaluated clinically after the primary fixation and following VAC application, for an average period of follow up of 12 months. Majority of patients required 4-5 VAC dressings. The mean decrease in wound size was 9.97 cm [21.22%]. Out of 30 patients, 4 patients had excellent, 16 patients had good, 8 patients had fair and 2 patients had poor result.
Conclusion: In this study, 30 patients were included with open fractures of tibia after primary internal fixation with VAC application. The greatest advantage of VAC was found to facilitate rapid formation of granulation tissue on wounds with exposed tissue and implants hence shorten healing time and minimize secondary soft tissue defect coverage procedures. This technique has indeed resulted in the effective decrease in wound size, and decrease in hospital stay and given a better functional outcome.
Keyword :
Vacuum assisted closure, Gustillo Anderson classification, Johner and Wruh criteria.