Application of Modified Vacuum Assisted Closure with Silver Materials in Chronic Infected Wound

Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Received November 29, 2007 Revised April 2, 2008 Accepted April 28, 2008 Address Correspondence: Jae Ho Jeong, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University Hospital, 317-1 Daemyung 5-dong, Nam-gu, Daegu 705-717, Korea. Tel: 053)620-3481/ Fax: 053)626-0705/E-mail: jhjeong@med.yu.ac.kr *본 논문은 2005년 제 58차 대한성형외과학회 학술대회에서 포스터 발표되었음. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.