Vacuum-assisted accelerated healing of postphlebitic ulcer | ||
| The Egyptian Journal of Surgery | ||
| Volume 40, Issue 2, April 2021 PDF (923.13 K) | ||
| DOI: 10.4103/ejs.ejs_49_21 | ||
| Authors | ||
| Mohmaed Moslem; Hesham S. Eldeen; Waleed Asker; Ahmed Elmetwally | ||
| Abstract | ||
| Background Chronic leg ulcers affect ∼1% of the adult population in developed countries. The cornerstones of these regimens are compression therapy and resolution of the cause. Topical negative pressure has been used to promote the healing of tissue defects. The aim of our study is to evaluate the efficacy of vacuum assisted compression (VAC) in ulcer healing. Patients and methods After the ethics committee’s institutional review board (IRB) under number MS.17.06.09, this prospective randomized controlled study was conducted on 30 patients presented to the Vascular Surgery Department between June 2017 and October 2018. The patient was randomly allocated into three groups; each group contained 10 patients: one group underwent conventional therapy, the second group underwent VAC therapy, and the third underwent combined VAC and conventional therapies. These groups were compared regarding ulcer size, presence of granulation tissue, and presence of infection. The VAC system was placed in situ for 3 weeks, and the dressing was changed every 5 days. Patients were evaluated clinically through follow-up clinic visits at first week, the second week, 1 month, and 3 months after the procedure, regarding depth, width, and breadth and ulcer closure percentage. Results The current study shows that compression plus VAC group had a statistically significant faster closure duration than other compression groups (<0.05). Approximately 50% of the studied cases in the compression plus VAC group had complete closure within 1 week of the procedure, and only 20% had total closure after 3 months. The compression group showed the worst wound closure rate after the procedure, as 80.0% of the studied group had complete closure after 3 months of operation. There was no statistically significant difference in sociodemographic characteristics between the studied techniques, except for occupation number of parity and bodyweight of the studied groups, which showed a nonstatistically significant difference (>0.05). Cases that were lost to follow-up were 10, 20, and 20% in the compression group, VAC group, and combined group. Conclusion Healing of venous ulcers is a complex process attributed to several elements. Although various parameters proved to positively affect the healing of venous ulcers in our study, large prospective multicenter studies are needed to provide well-defined outcomes. | ||
| Keywords | ||
| postphlebitic syndrome; postphlebitic ulcer; vacuum-assisted therapy | ||
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