Abstract

Wound healing is a complex and dynamic process that includes an intricate sequence of cell migration leading to repair and closure. When wound fails to undergo this sequence of events, a chronic open wound is formed without anatomical or functional integrity. Negative pressure wound therapy (NPWT) has had a major impact in the management in orthopedic injuries. This is a Prospective study of 32 patients with Gustilo Anderson type 2, 3a, 3b open fractures. Inspection of wound site was done at the start of the therapy and then again at the end of NPWT and serial measurement of the VAC drain done. Out of 32 wounds taken in the study, 25 showed development of adequate granulation tissue with 20 wounds that reduced in area and were resurfaced with split thickness skin grafting and 5 wounds showed reduction in area and were subjected to secondary closure. The remaining 5 wounds were subjected to second round of NPWT. During start of vaccum assisted closure (VAC) dressing therapy, all wounds were infected confirmed with pus cultures. At the end of VAC dressing, all wounds became microbial swab negative. Our study shows that Vacuum assisted closure therapy has good functional outcome for patients with compound fractures and post-operative infective wounds.

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