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Vacuum-Assisted Closure (V.A.C.®) for Temporary Coverage of Soft-Tissue Injury in Type III Open Fracture of Lower Extremities

Labler, Ludwig ; Keel, Marius ; Trentz, Otmar

In: European Journal of Trauma, 2004, vol. 30, no. 5, p. 305-312

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    Titre
    • Vacuum-Assisted Closure (V.A.C.®) for Temporary Coverage of Soft-Tissue Injury in Type III Open Fracture of Lower Extremities
    Auteur
    • Labler, Ludwig. Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland
    • Keel, Marius. Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland
    • Trentz, Otmar. Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317209
    Summary
    Abstract : Background and Purpose: : The difficulty in the treatment of severe open fractures is a high infection rate and the problem of an adequate temporary coverage of the soft-tissue damage between successive second-look operations. The vacuum-assisted closure (V.A.C.®) offers good temporary soft-tissue coverage with a proven bacterial clearance and protects, at the same time, the soft tissue against secondary damage. The retrospective study reports the soft-tissue management of severe open fractures of Gustilo type IIIA and IIIB with V.A.C.® or Epigard®. Patients and Methods: : All open fractures were in the lower extremity and a result of a nonpenetrating trauma. V.A.C.® was used as a temporary dressing in 14 fractures and an Epigard® in twelve fractures. Results: : One early amputation was observed in each group. In the group with the soft-tissue coverage by Epigard®, in spite of less type IIIB fractures and less polytraumatized patients, the rate of infections (6/11) was substantially higher compared with patients managed by V.A.C.® therapy (infection: 2/13). Conclusion: : V.A.C.®, a temporary soft-tissue substitute, reduces the rate of infection and is an alternative of choice for the management of type III open fractures