Optimierung der Vakuumtherapie bei ausgedehnten Wundtaschen

INTRODUCTION: Extensively undermined wound cavities represent a common surgical problem. By a modified vacuum therapy the healing of such wounds can be accelerated. MATERIALS AND METHODS: Based on our experience in selected cases with wound healing disorders or extremely undermined wounds following degloving injuries or abscess formations the application of topical negative pressure therapy to fix wound margins to the wound ground while at the same time allowing exudates emission with additional drainages is described. RESULTS: In 5 patients we were able to demonstrate the efficacy of vacuum dressing system described here with successful and lasting adaptation of the wound margins to the defect. All wounds were brought to permanent healing. CONCLUSION: Extensive tissue degloving and wound healing disorders after excessive tissue mobilization during plastic surgical defect coverage can be treated successfully with topical negative pressure therapy (TNP). Whereas longterm complete conventional polyurethane foam lining of wound cavities is an effective method and may be necessary in special situations, the application of TNP can lead to a firm adhesion of wound margins in extensive subcutaneous or epi-fascial wounds to the undersurface. To avoid exudate formation in the adjoining tissue TNP can be effectively optimized by the placement of drainage tubes into the surrounding tissue.