Comparing conventional gauze therapy to vacuum-assisted closure wound therapy:: A prospective randomised trial

Background: Vacuum-assisted closure wound therapy (vacuum therapy) has been used in our department since 1997 as a tool. to bridge the period between debridement and definite surgical closure in full-thickness wounds. We performed a prospective randomised ctinicaL trial to compare the efficacy of vacuum therapy to conventional moist gauze therapy in this stage of wound treatment. Methods: Treatment efficacy was assessed by semi-quantitative scoring of the wound conditions (signs of rubor, calor, exudate and fibrinous slough) and by wound surface area measurements. Tissue biopsies were performed to quantify the bacterial. load. Besides this, the duration until 'ready for surgical therapy' and complications encountered during therapy and postoperatively were recorded. Results: Fifty-four patients were included (vacuum n = 29, conventional n = 25). With vacuum therapy, healthier wound conditions were observed. Furthermore, a tendency towards a shorter duration of therapy was found, which was most prominent in late-treated wounds. In addition, the wound surface area reduced significantly faster with vacuum therapy. Surprisingly, these results were obtained without a decrease in the number of bacteria colonising the wound. Complications were minor, except for one case of septicaemia and one case of increased tissue necrosis, which compelled us to stop vacuum therapy. For the treatment of full-thickness wounds, vacuum therapy has proven to be a valid wound heating modality. (c) 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.