Comparison of the Vacuum Assisted Closure (VAC) dressing and gauze dressing in the management of acute traumatic wounds

Abstract

Background: Vacuum assisted closure dressing is a relatively new concept that has been shown to promote wound healing. This study aimed to investigate the effect of vacuum assisted closure therapy on granulation tissue formation, wound size and the limb circumference at the site of the wound, in comparison to gauze dressing on acute traumatic wounds in the lower limbs. Methodology: Forty-four wounds, on forty two patients, were randomly allocated to treatment with either vacuum assisted closure or gauze dressing. The end point was 100% granulation tissue. The wound surface area, diameter and limb circumference were measured every three days. Results: Wounds managed by vacuum assisted closure achieved 100% granulation tissue formation faster ( median time 12 days compared with 21days), had a higher probability of achieving this (hazard ratio 7.6) and had a significant reduction in wound size (0.79cm2 compared to 0.23cm2 , P value < 0.001) compared to wounds managed by gauze dressing. There was also a significant reduction of the limb circumference at the site of the wound (0.47cm compared with 0.09cm, P value <0.001) for patients whose wounds were managed by vacuum assisted closure compared to those whose wounds were managed by gauze dressing. Conclusion: Vacuum assisted closure dressing is more effective than gauze dressing in the management of acute traumatic wounds in terms of formation of granulation tissue, reduction in wound size and reduction of limb circumference at the site of the wound.