Negative Pressure Wound Therapy; Cases Need Prolonged Therapy for More Than Four Weeks for Wound Healing

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  • 4週間をこえて陰圧閉鎖療法を施行した症例の検討

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Negative pressure wound therapy (NPWT) is effective for granulation tissue formation and accelerating wound healing. NPWT using the V.A.C. ATS system is covered by national health insurance for a period of four weeks. Thirty-seven patients with refractory ulceration including post-surgical wound dehiscence, diabetic ulcers, PAD, and venous leg ulceration were treated with the V.A.C. ATS system between December 2010 and April 2012. Thirty-two patients were included in the analysis. Complete wound healing was achieved in 25 patients (78 percent) within four weeks of VAC therapy. On the other hand, 7 patients (22 percent) needed to continue with NPWT after 4 weeks of VAC therapy because of insufficient wound healing, incomplete coverage of bone exposure, and pocket formation. Complete wound healing was observed at the end of VAC therapy in 5 patients after additional NPWT and surgical intervention. The average duration of additional NPWT was 43 days. No significant differences were observed in patient characteristics or laboratory data between these two groups. Although VAC therapy is widely used and an effective method for wound treatment, some patients need prolonged NPWT for more than four weeks. A suitable duration of NPWT may need to be elucidated to obtain effective wound healing course.

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