J Korean Surg Soc.  2009 Dec;77(Suppl):S25-S28. 10.4174/jkss.2009.77.Suppl.S25.

Successful Closure of Fasciotomy Wound by Application of Topical Negative Pressure

• Kang J

• KMID: 1464798
• DOI: http://doi.org/10.4174/jkss.2009.77.Suppl.S25

Abstract

Fasciotomy wounds are a major contributor to prolonged hospital stay and can lead to amputation. Although it is generally recommended to close the fasciotomy wound as early as possible, it is usually challenging. Primary closure is more favorable because it commences more functional and esthetic results with less morbidity. But primary closure is difficult to achieve due to skin edema, retraction and necrosis. Topical negative pressure care (TNP) has been used in other areas of wound care, such as mediastinitis and burn wounds. TNP has recently gained popularity and has shown promising outcomes. Topical negative pressure systems are commercially available but very expensive. We designed a modified negative pressure system with wall-suction and applied it to a complicated fasciotomy wound. We herein report our experience with a review of related literatures.

Keyword

Topical negative pressure; Fasciotomy; Wound; Vacuum

MeSH Terms

Amputation
Burns
Edema
Length of Stay
Mediastinitis
Necrosis
Skin
Vacuum

Figure

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  Fig. 1 (A) Preparation of topical negative pressure dressing. Proper caliber chest tube is buried within the foam, thereafter this system is wrapped air-tight with surgical drapes. Caution must be addressed at the site of tube exit while wrapping. Draining-tube must be wrapped circumferentially. (B) Modified topical negative pressure system (TNP). TNP is applied at operating room using surgical drape, chest tube and foam. The air leakage test must be done at operation site by wall-suction after sealing with surgical drapes.

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  Fig. 2 Final state of fasciotomy wound. The complicated fasciotomy wound can be closed successfully.

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  Fig. 3 Components of VAC*. Commercially available TNP system is developed. Vacuum Assisted Closure system (VAC®, KCI, San Antonio, TX, USA).

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