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The use of vacuum assisted closure (VAC™) in soft tissue injuries after high energy pelvic trauma

Labler, Ludwig ; Trentz, Otmar

In: Langenbeck's Archives of Surgery, 2007, vol. 392, no. 5, p. 601-609

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    Titre
    • The use of vacuum assisted closure (VAC™) in soft tissue injuries after high energy pelvic trauma
    Auteur
    • Labler, Ludwig. Division of Trauma Surgery, Department of Surgery, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Trentz, Otmar. Division of Trauma Surgery, Department of Surgery, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Langenbeck's Archives of Surgery, 2007, vol. 392, no. 5, p. 601-609. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318505
    Summary
    Background: Application of vacuum-assisted closure (VAC™) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. Materials and methods: Between 2002 and 2004, 13 patients were treated for severe soft tissue injuries in the pelvic region. All musculoskeletal injuries were treated with multiple irrigation and debridement procedures and broad-spectrum antibiotics. VAC™ was applied as a temporary coverage for defects and wound conditioning. Results: The injuries included three patients with traumatic hemipelvectomies. Seven patients had pelvic ring fractures with five Morel-Lavallee lesions and two open pelviperineal trauma. One patient suffered from an open iliac crest fracture and a Morel-Lavallee lesion. Two patients sustained near complete pertrochanteric amputations of the lower limb. The average injury severity score was 34.1 ± 1.4. The application of VAC™ started in average 3.8 ± 0.4days after trauma and was used for 15.5 ± 1.8days. The dressing changes were performed in average every 3days. One patient (8%) with a traumatic hemipelvectomy died in the course of treatment due to septic complications. Conclusion: High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC™ as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closure