ABSTRACT Background: Vacuum-assisted dressing is a noninvasive closure system of the wound, which makes localized and controlled negative pressure. Its mechanical tension reduces edema, stimulates granulation tissue formation and angiogenesis, and prepares the wound bed for closure. In this study, a patient has been presented, who suffered from serious lower extremity wounds due to arterial emboli, one of her wounds has been treated with vacuum-assisted dressing and the other with conventional dressing to evaluate the efficacy of vacuum-assisted dressing in acute ischemic wounds. Methods: A 65-year-old female patient was admitted to the emergency clinic, due to complaint of severe pain in her right lower extremity which suggested an acute arterial occlusion. She immediately underwent an embolectomy operation; however, a few days later, severe ischemia on the leg and foot became appearant. All of the necrosis was sharply debrided under sterile conditions in the operating room, and then lower leg wound was covered with vacuum-assisted dressing, also calcaneal wound was dressed with silver sulphadiazine. Results: Eighteen days after the first dressing with negative pressure, distal leg wound became ready for closure, whereas, enough granulation tissue over the calcaneal area developed merely thirty-four days later. Calcaneal wound closed spontaneously within fifty-three days. Conclusions: When dealing with this experience, using the negative pressure dressing in patient with severe lower limb wounds following arterial emboli, accelerates wound healing by means of developing the granulation tissue, and rapidly prepares the wound for closure, so it may reduce the risk of amputation.
Cite this paper
N. Gümüş, "Postischemic Lower Extremity Wounds Treated with and without Negative Pressure Dressing," Surgical Science, Vol. 3 No. 7, 2012, pp. 376-380. doi: 10.4236/ss.2012.37075.
 L. C. Argenta, M. J. Morykwas, M. W. Marks, A. J. De-Franzo, J. A. Molnar and L. R. David, “Vacuum-Assisted Closure: State of Clinic Art,” Plastic and Reconstructive Surgery, Vol. 117, No. 7, 2006, pp. 127S-142S.
 A. Braakenburg, M. C. Obdeijn, R. Feitz, I. A. L. M. Van Rooij, A. J. Van Griethuysen and J. H. G. Klinkenbijl, “The Clinical Efficacy and Cost Effectiveness of the Vacuum-Assisted Closure Technique in the Management of Acute and Chronic Wounds: A Randomized Controlled Trial,” Plastic and Reconstructive Surgery, Vol. 118, No. 2, 2006, pp. 390-397.
 S. S. Scherer, G. Pietramaggiori, J. C. Mathews, M. J. Prsa, S. Huang and D. P. Orgill, “The Mechanism of Action of the Vacuum-Assisted Closure Device,” Plastic and Reconstructive Surgery, Vol. 122, No. 3, 2008, pp. 786-797.
 D. M. Schaffzin, J. M. Douglas, T. J. Stahl and L. E. Smith, “Vacuum-Assisted Closure of Complex Perineal Wounds,” Diseases of the Colon & Rectum, Vol. 47, No. 10, 2004, pp. 1745-1748. doi:10.1007/s10350-004-0633-9
 S. Cresti, M. Oua?ssi, I. Sielezneff, J. B. Chaix, N. Pirro, B. Berthet, B. Consentino and B. Sastre, “Advantage of Vacuum Assisted Closure on Healing of Wound Associated with Omentoplasty after Abdominoperineal Excision: A Case Report,” World Journal of Surgical Oncology, Vol. 6, 2008, p. 136. doi:10.1186/1477-7819-6-136
 S. Kumar, M. E. O’Donnell, K. Khan, G. Dunne, P. D. Carey and J. Lee, “Successful Treatment of Perineal Necrotising Fasciitis and Associated Pubic Bone Osteomyelitis with the Vacuum Assisted Closure System,” World Journal of Surgical Oncology, Vol. 6, 2008, pp. 67-69.
 R. Bronchard, C. Vaumas, S. Lasocki, K. Jabbour, A. Geffroy, N. Kermarrec and P. Montravers, “Vacuum-Assisted Closure in the Treatment of Perineal Necrotizing Skin and Soft Tissue Infections,” Intensive Care Medicine, Vol. 34, No. 7, 2008, pp. 1345-1347.
 L. Labler and O. Trentz, “The Use of Vacuum Assisted Closure in Soft Tissue Injuries after High Energy Pelvic Trauma,” Langenbeck’s Archives of Surgery, Vol. 392, No. 5, 2007, pp. 601-609.
 B. E. Leininger, T. E. Rasmussen, D. L. Smith, D. H. Jenkins and C. Coppola, “Experience with Wound VAC and Delayed Primary Closure of Contaminated Soft Tissue Injuries in Iraq,” The Journal of Trauma and Acute Care Surgery, Vol. 61, No. 5, 2006, pp. 1207-1211.
 E. T. Powell IV, “The Role of Negative Pressure Wound Therapy with Reticulated Open Cell Foam in the Treatment of War Wounds,” Journal of Orthopaedic Trauma, Vol. 22, Suppl. 10, 2008, pp. S138-S141.
 D. J. Marsh, G. Abu-Sitta and H. Patel, “The Role of Vacuum-Assisted Wound Closure in Blast Injury,” Plastic and Reconstructive Surgery, Vol. 119, No. 6, 2007, pp. 1978-1979. doi:10.1097/01.prs.0000259773.52889.68
 P. A. Blume, J. Walters, W. Payne, J. Ayala and J. Lantis, “Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers,” Diabetes Care, Vol. 31, No. 4, 2008, pp. 631-636. doi:10.2337/dc07-2196. doi:10.2337/dc07-2196
 M. P. Clare, T. C. Fitzgibbons, S. T. McMullen, R. C. Stice, D. F. Hayes and L. Henkel, “Experience with the Vacuum Assisted Closure Negative Pressure Technique in the Treatment of non-Healing Diabetic and Dysvascular Wounds,” Foot & Ankle International, Vol. 23, No. 10, 2002, pp. 896-901.
 J. Nordmyr, S. Svensson, M. Bjorck and S. Acosta, “Vacuum Assisted Wound Closure in patients with Lower Extremity Arterial Disease. The Experience from Two Tertiary Referral-Centers,” International Journal of Angiology, Vol. 28, No. 1, 2009, pp. 26-31.