J Korean Soc Plast Reconstr Surg.  1999 Sep;26(5):1082-1086.

New Method for Wound Healing Using V.A.C.(Vacuum-assisted Closure)

• Hong JG
• Chang DM
• Lee PK
• Kim YJ

Abstract

Healing is an intricate, interdependent process that involves complex interactions between cells, the microcellular environment, biochemical mediators and extracellular matrix molecules. The goals of wound healing are to minimize bloods loss, to replace any defect with new tissue, and to restore an intact epithelial barrier as rapidly as possible. The rate of wound healing is limited by the available vascular supply and the rate of formation of new capillaries and matrix molecules, which are heavily influenced by locally-acting growth factors that affect proliferation, angiogenesis, chemotaxis, gene expression, proteinases, and protein production. We present a new method for wound control and treatment, the V.A.C (vacuum-assisted closure) technique. It places open-cell foam dressing into the wound cavity and applies subatmospheric pressure. The application of subatmospheric pressure accelerates the rate of wound healing by the foollowing two mechanisms: 1. Removal of excessive interstitial fluids, which decrease localized edema, reduce concentration of inhibitory factors, and increase local blood flow. 2. Transmission of mechanical forces to surrounding tissues with resultant deformation of the extracellular matrix and cells, which then increase protein and matrix synthesis as well as cell proliferation. We applied it to 17 patients: 1 Livedo vasculitis, 1 burned by flame 3 pressure sores, 1 extravasation injury, 1 wound infection, 2 wound disruption, and 8 diabetes mellitus feet. In the end, most of the remaining wounds were treated with a simple split-thickness skin graft and the results were encouraging. We concluded that the V.A.C technique may be an effective substitute to help promote wound healing. It could be especially helpful in chronic complicated wounds in aging or debilitated patients who can not tolerate aggressive surgical procedures.

MeSH Terms

Aging
Bandages
Burns
Capillaries
Cell Proliferation
Chemotaxis
Diabetes Mellitus
Edema
Extracellular Fluid
Extracellular Matrix
Foot
Gene Expression
Humans
Intercellular Signaling Peptides and Proteins
Peptide Hydrolases
Pressure Ulcer
Skin
Transplants
Vasculitis
Wound Healing*
Wound Infection
Wounds and Injuries*
Intercellular Signaling Peptides and Proteins
Peptide Hydrolases