03/07/2025
Vacuum-assisted closure (VAC) or negative pressure wound therapy (NPWT) is indicated for a variety of wounds, including diabetic foot ulcers, pressure ulcers, venous ulcers, traumatic wounds, and wounds following surgery that are not healing well. It's also used for skin grafts, flaps, and burns. VAC therapy helps to reduce wound volume, depth, and treatment duration, decrease the need for plastic procedures, improve patient comfort, and potentially decrease morbidity and cost.
Specific indications for VAC therapy include:
Diabetic foot ulcers:
VAC therapy can be particularly helpful for diabetic foot ulcers that have exposed tendons, fascia, or bone after debridement.
Pressure ulcers:
These can be challenging to heal, and VAC therapy can aid in their management.
Venous ulcers:
Similar to pressure ulcers, venous ulcers can benefit from the accelerated healing provided by VAC therapy.
Traumatic wounds:
Recent traumatic injuries that are open and not readily closed with sutures or other methods can be treated with VAC therapy.
Surgical wounds:
These include wounds that have dehisced (opened) or are not healing as expected.
Skin grafts and flaps:
VAC therapy can be used to secure and promote healing of skin grafts and flaps.
Burns:
Both partial and full thickness burns can be treated with VAC therapy.
Wounds with exposed bone or tendon:
In cases where these structures are exposed after debridement, VAC therapy can help create a moist environment conducive to healing.
Wounds with excessive drainage:
VAC therapy helps to remove excess fluid and exudate from the wound, promoting a healthy healing environment.
Chronic wounds:
These are wounds that have not healed in a reasonable amount of time and may be related to underlying conditions like diabetes.
Wounds in the elderly with comorbidities:
VAC therapy can be a valuable tool for managing complex wounds in older patients with other health issues.
Contraindications for VAC therapy include:
Exposed blood vessels or organs: If there is a risk of damaging vital structures, VAC therapy may not be appropriate.
Active infection: While VAC therapy can be used in some infected wounds after debridement, it's not suitable for wounds with uncontrolled infection.
Necrotic tissue: Dead tissue must be removed before VAC therapy can be effective.
Malignancy in the wound bed: Cancerous tissue should not be treated with VAC therapy.
Fistulas to organs or body cavities: If there is a tunnel or abnormal connection to an internal organ, VAC therapy may not be suitable.
