What does Vac mean in electrical terms
Synonyms: vacuum sealing therapy, vacuum sealing
English: vacuum assisted closure therapy (VAC), negative pressure wound therapy (NWPT)
The Vacuum therapy is a form of wound care in which wounds are covered airtight and a slight negative pressure is created in the wound area, which should have a beneficial effect on healing.
The wound is covered with large-pore wound sponges and a drainage system is placed on the sponge. Both are sealed airtight with foil. Secretions are sucked off continuously or at intervals. The negative pressure load on the wound can be regulated. There are mobile and stationary devices, depending on the extent of the wound and the indication.
The procedure is controversial. It is assumed that there is a positive effect on wound healing compared to conventional wound treatment. The study situation is currently (2020) ambiguous. Further randomized controlled trials (RCTs) are necessary to evaluate the procedure.
3 types of sponges
The sponges used can be made of different materials. A distinction is made between PVA sponges made from polyvinyl alcohol (PVA) and PU sponges made from polyurethane (PU). With sponges made of PVA, a longer period of time in the wound area can be tolerated than with PU sponges.
Possible indications include:
Vacuum therapy is contraindicated for:
Particular caution is required with:
The procedure requires just as thorough screening of the wound as with conventional wound treatment. It should only be used by appropriately trained personnel. In individual cases, deaths have occurred with the use of vacuum therapy.
Previous Cochrane meta-analyzes came to the following conclusions:
Vacuum therapy for open traumatic wounds (e.g. animal bites, gunshot wounds, open fractures) showed no advantage over standard therapy with regard to the healing rate of wounds, so that it is not a cost-effective treatment. It remains very uncertain whether it can reduce the likelihood of wound infections. Further studies are necessary for a precise assessment of the evidence, especially with regard to the benefits and risks of:
- Treatment of surgical wounds with secondary wound healing
- Treatment of diabetic foot wounds
- Leg ulcer treatment
- Treatment of second degree burns
The Institute for Quality and Efficiency in Health Care (IQWiG) explains: "From the results of the studies with high qualitative certainty of results (Ashby 2012, Llanos 2006) no indication of an effect on wound healing can be derived." Only with the inclusion of moderate clinical studies can statistically representable advantages for wound healing be found.
- Peinemann and Sauerland: Vacuum Therapy of Wounds Dtsch Arztebl Int 2011; 108 (22): 381-9; DOI: 10.3238 / arztebl.2011.0381
- Ruchholz and Wirtz: Orthopedics and trauma surgery essentials: Intensive course for further training. 2nd edition, 2012. Thieme Verlag
- Wild and Auböck: Manual of wound healing: Surgical-dermatological guidelines for modern wound treatment. Edition 2007. Springer Verlag
- ↑ Iheozor-Ejiofor Z et al. Vacuum Therapy for the Treatment of Open Traumatic Wounds, Cochrane.org, published July 3, 2018, accessed July 16, 2019
- ↑ Dumville JC et al. Negative pressure wound therapy for the treatment of surgical wounds with secondary wound healing (open surgical wounds), Cochrane.org, published on June 4, 2015, accessed on July 16, 2019
- ↑ Liu Z et al. Negative pressure wound therapy for the treatment of diabetic foot wounds, Cochrane.org, published on October 17, 2018, accessed on July 16, 2019
- ↑ Dumville JC et al. Negative pressure wound therapy for the treatment of leg ulcers, Cochrane.org, published 07/14/2015, accessed 07/16/2019
- ↑ Dumville JC et al. Negative Pressure Wound Therapy (NPWT) for the treatment of second degree burns, Cochrane.org, published December 15, 2014, accessed July 16, 2019
- ↑ Vacuum sealing therapy of wounds with intended secondary wound healing. IQWiG reports - No. 713.
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