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| Chronic open, nonhealing wounds pose a continual challenge in medicine. Our objective was to evaluate vacuum-assisted closure (VAC) therapy's ability to improve the healing rate of chronic wounds compared to the traditional saline-wet-to-moist (WM) dressings. Twenty-four patients with 36 chronic, nonhealing wounds were enrolled in the study after obtaining proper consent. Subjects were randomized to the VAC group or the control group. Biopsies and wound measurements were obtained by blinded independent wound evaluators. The most significant difference was the change in depth of 66 percent for V.A.C. compared to 20 percent for WM (p<.0001). Histologically, the groups exhibited different characteristics. In the WM group, 81 percent (n=13) displayed inflammation and fibrosis. The chief characteristic of the VAC group was granulation tissue formation in 64 percent (n=9) of those wounds. The VAC system should be used to obtain wound closure, especially of chronic non healing with great depth, rather than the traditional saline WM dressings. |
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