Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review

Purpose To determine the effectiveness of Vacuum-Assisted Closure Device in the postoperative wound care for Fournier's gangrene Methods We performed a systematic review in the following databases: Medline (Ovid), EMBASE, and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included RCTs and analytical observational studies. Meta-analysis was not possible given the clinical and methodological heterogeneity of the studies. Results We included six studies that compared VAC treated patients and a control group. The length of stay of the VAC treated vs. the conventional dressing treated patients was higher for the VAC treated patients in all but one of the included studies. The VAC group had the highest number of surgical debridements requiring anesthesia. The conventionally treated patients had a higher number of daily dressings, and the need for additional dressing changes, without anesthesia. Two studies found significantly higher mean scores for VAS, requiring a higher need for daily analgesics for the control group patients. Conclusions VAC therapy is an effective method, but it is not better than conventional dressing treatment. VAC carries fewer dressing changes, less pain, and less need for analgesics, but it comes with a higher need for surgical interventions requiring anesthesia.