Wound VAC: vacuum-assisted closure of a wound

How does VAC work? 

This wound therapy includes a vacuum pump, a special wound dressing, a canister to collect fluid, and tubing.

The device draws the wound edges together by creating a vacuum over the wound site. This promotes the development of collagen-rich granulation tissue to help the body heal the wound.

To begin, the doctor debrides the wound to remove necrotic tissue. We then cover the wound with a foam dressing and seal it with a transparent drape. A drainage tube is then attached to the foam and installed in the vacuum pump.

The pump draws fluid through the foam and into the drainage tubing. The doctor will decide if the pump should run constantly — such as for a skin graft — or cycle off and on. Always work with a skilled wound care surgeon to ensure the proper technique is being used for your type of wound.

What are the benefits of VAC wound therapy? 

VAC therapy makes use of the latest technological advantages in wound care. The VAC therapy system monitors the pressure at the wound bed and adjusts it to achieve the exact amount of negative pressure necessary throughout the treatment. This therapeutic regulated wound care can:

• Monitor and sustain a target pressure.
• Reduce tubing blockages by drawing away fluids.
• Present alarms for patient safety.
• Increase patient comfort.
• Adjust the pump output to adjust for wound size.
• Stimulate new tissue growth.
• Reduces edema (fluid buildup).
• Pull the edges of the wound together, reducing wound size.
• Increase the speed of fluids moving through the blood vessels in the area.
• Reduce the need for amputation.

How long does VAC therapy last?

You will probably use the wound management system for several weeks or months. Your provider will schedule follow-up visits during your recovery to monitor your progress and advise on how much longer you must use the VAC system.

The VAC dressing must be changed at least once a day — and sometimes more often. When possible, we will teach you to do this yourself, or a visiting healthcare provider or caregiver can change the dressing for you. During your healing, you will have a portable VAC pump for mobility.

However, for severe wounds, you may need to spend some time in a hospital or convalescent facility. This allows more consistent monitoring of your progress.

During your VAC therapy, we can prescribe pain medication to decrease any discomfort. We all recommend a nutritious diet and ample sleep to will aid wound healing. The doctor can explain foods that are best for recovery.

If you smoke, stop! The toxic substances in cigarette smoke (especially nicotine, carbon monoxide, and hydrogen cyanide) significantly impair your body's ability to heal.

Wound VAC for treatment of diabetic foot ulcers

Though used since the 1990s for other types of surgery, it is only recently that foot and ankle surgeons began using wound VAC as a treatment for soft tissue diabetic foot wounds. At UFAI, our foot and ankle doctors use VAC wound therapy to help close:

• diabetic foot ulcers
• bed sores
• pressure ulcers
• wounds secondary to peripheral vascular disease

Patients suffering from diabetic ulcers, chronic ostomy wound management peripheral neuropathy, wound dehiscence, and high-risk patients with chronic lower extremity ulcers benefit from vacuum-assisted closure therapy. Proper use of VAC therapy can also prevent the need for further surgery.

Researchers found that over 2.5 months of VAC therapy, chronic wounds or ulcers in patients with diabetes or peripheral vascular disease healed quicker than with traditional methods. VAC therapy has also been shown to be more effective than traditional moist wound dressing for diabetic foot care.

What are potential wound VAC therapy complications? 

Though considered safe, wound VAC carries some rare risks. These include:

• bleeding from the wound
• infection

Correct dressing changes help lessen the risk of these problems. Follow any postoperative instructions given by your surgeon to ensure proper healing and lower your risk of complications.

Am I a good candidate for VAC? 

The best candidates for VAC are those with complicated or chronic wounds.

However, some conditions can increase the risk of complications. We do not recommend VAC if you have:

• high risk of bleeding
• wound contamination
• bone infection
• non-healing wound tissue
• cancer
• aging skin or longtime use of topical steroids
• allergies to the bonding agent
• poor blood flow to the wound
• wounds close to joints in danger of reopening

Why trust your surgical wounds to UFAI?

It should not be a surprise that foot and ankle pain are widespread. The American Podiatric Medical Association reports that 77% of adults have experienced foot pain, which is constant for 80% of those. 

One of the great things about modern medicine is that our surgical team is well-versed in treating every part of the human body. An orthopedic foot and ankle specialist will keep you walking strong regarding the often-neglected feet. That’s where we come in.

With decades of combined experience and the highest success rates in the nation, UFAI providers have treated more than 200,000 patients. We are one of the country's most technologically advanced foot and ankle practices.

UFAI’s surgeons are at the forefront of research, education, product design, regenerative medicine, and foot and ankle care advancements. Our non-profit foundation educates surgical fellows in advanced foot, ankle treatment, and surgery, has performed dozens of clinical trials and has educated the community for 20 years.

Director Dr. Bob Baravarian — a Board-Certified Podiatric Foot and Ankle Specialist — is one of only a handful of foot and ankle clinicians to have both foot and reconstructive foot and ankle certifications as a Fellow of the American College of Foot and Ankle Surgeons.

Sources:

Armstrong DG, Lavery LA, Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomized controlled trial. Lancet. 2005; 366: 1704–10. 

Johns Hopkins: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vacuumassisted-closure-of-a-wound

National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/16174508/