Abstract

Vacuum-assisted closure (VAC) in the management of the soft tissue component of open tibia fractures helps in healing of wound via a sealed sponge or foam dressing, removing fluid and exudate, and encouraging blood flow to the wound site. Present study was aimed to study outcome of vacuum assisted closure in open fractures of tibia at a tertiary hospital. Material and Methods: Present study was single-center, prospective, comparative, parallel-group, observational study, conducted in patients aged above 18 years of age, haemodynamically stable with open fractures of tibia {G.A.II, IIIA, and IIIB} undergone primary internal fixation and Vacuum assisted closure (VAC) application. Results: Among 30 patients in present study, majority were male (83.33 %), mean age was 41.34 ± 14.56 years. The frequency of VAC dressing application was every 4 day per dressing from the second day of post-operative period, 5 times VAC dressing done in 15 cases (50 %), 4 times VAC dressing done in 10 cases (33.33 %) & > 5 times VAC dressing done in 5 cases (16.67 %). Mean Hospital stay was 18.82 ± 9.46 days. Post-primary Procedure, majority had Split skin-graft (63.33 %), Repeat debridement and then secondary closure (16.67 %), Direct closure (10 %), Tissue transfer (6.67 %) & healing by secondary intension (3.33 %). Mean decrease in wound size was 10.23 ± 3.72 cm2. Complications observed were implant related infection in 2 cases (6.67 %) & exposed implant in 1 case (3.33 %). Functional outcome at 1 year follow up was excellent in 3 cases (10 %), good in 17 cases (56.67 %), fair in 9 cases (30 %) & poor in 1 case (3.33 %). Conclusion: VAC application reduces wound infection rate, shortens the healing time and reduces the number of secondary soft tissue defect coverage procedure.

Description