Comparative study of VAC in the preoperative and postoperative treatment of bedsore united with skin flap

Objective To investigate the clinical efficacy and mechanism of vacuum-assisted closure (VAC) in the preoperative and postoperative treatment of bedsore united with skin flap. Methods Twenty two cases with bedsore were randomly divided into experimental and control groups. In the control group, the surgery of flap was performed after the treatment of continuous negative pressure about 7-10 days and the VAC was not applied after operation. While in the experimental group, VAC was not used before operation. It was applied on flaps as soon as sutured the border of flap and decubitus ulcers and removed after 7-10 days. By comparing the general appearance of two groups, microvessel count and the detection rate of bacterial culture and other indicators, the clinical effects of two treatments were investigated and the preliminary mechanism was analyzed. Results After preoperative VAC treatment, 11 cases of control group showed a little granulation tissue growth, less subcutaneous hematoma and wound effusion, increased microvessel count and negative bacterial culture. However, there were 4 cases of death cavity residual, subcutaneous hematoma and wound effusion, positive bacterial culture and another 4 cases of delayed healing with skin flap repairing bedsore. The application of VAC in experimental group showed close contact of flap with the basement, less effusion, increased microvessel count and negative bacterial culture. One case of skin flap had a small area of separation, after the dressing of skin and the flap survived. The other wounds healed by first intention. Conclusions The use of VAC to repair bedsore can reduce the number of operation, and it is beneficial to the flap survival. Key words: Surgical flaps; Pressure ulcer/SU; Negative-pressure wound therapy; Drainage