Vacuum assisted closure therapy

VAC therapy also known as negative pressure wound therapy (NPWT) is a method of delayed wound closure, where in primary closure is not possible. this PPT details the make & model of the device, its modifications, principle , mechanism , advantages and disadvantages

1. VACUUM ASSISTED CLOSURE (VAC) THERAPY UG BATCH- 2017 Date-10/9/21 Dr. Ankita Singh Assistant Professor Department of Surgery

2. Introduction Also known as NPWT Negative pressure- assisted wound therapy Principle: Creation of sub-atmospheric / negative pressure over a wound surface promotes healing Pressure: -70 to -200 mmHg (-125) Intermittent/ continuous

3. Mechanisms R educes fluid in the interstitial space reduces oedema Removal of wound exudate Keeps wound moist Increases local blood flow I ncreases the cell proliferation Increases protein matrix synthesis

4. Mechanisms.. Stimulates granulation tissue Increases capillary caliber Stimulates endothelial proliferation Angiogenesis Microstrains & macrostrains : 3 D stresswithin cells & across whole area of wound respectively Increase cellular proliferation & higher microvessel density

5. Mechanisms.. Alters wound fluid composition Removes deleterious proteinases & inflammatory cytokines e.g., MMP-1,2,9, IL-1 β & TNF- α Up-regulation of VEGF, TGF- β 1, TIMP-1 Significantly increases growth factors, decrease inflammatory cytokines & normalize MMP activity

6. Advantages Significant improvement in wound depth/size Accelerated wound healing Accelerated wound bed preparation & granulation tissue formation Improved rated of graft take Decreased drainage time for acute wounds Reduced complications Increased patient survival Decreased cost (cost effective)

7. Issues Shown to increase bacterial counts, despite increased wound healing Availability

8. Indications Closure of wounds, wherein primary closure is not possible Diabetic wounds, ischemic ulcers, complex surgical or trauma wounds with/ without contamination & burns Acute, subacute , chronic wounds

9. Make & Model- conventional Composition Sterile filler- foam/ gauze dressing Sterile adhesive film Drainage tubing- perforated end Collecting canister Suction system (vacuum pump) with display Battery/charging system/ electricity

10. Modifications NPWT/VAC device with instillation Irrigation by sterile fluids Removal of thick exudate & infectious products Portable VAC device Suitable for outpatient treatment

11. How to apply VAC

12. Thank you