Comparison of vacuum assisted closure therapy with conventional dressing in the management of necrotizing fasciitis wound

Authors

  • Birbal Kumar Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • R. S. Mohil Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • Sajith K. Mohan Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India http://orcid.org/0000-0003-4341-6703
  • Navnik Singh Bhardwaj Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • Arush Pasricha Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • Kashinath Singh Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • Raghav Garg Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India
  • Ratnakar Namdeo Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20214750

Keywords:

NF, Necrotizing soft tissue infections, NPWT, VAC therapy, Conventional dressing

Abstract

Background: The purpose of our study was to compare the effect of vacuum assisted closure (VAC) therapy and conventional dressings in patients with open wounds due to necrotizing fasciitis (NF) on the basis of healing rate, infection control, frequency of dressing and pain score.

Methods: The study evaluated 50 patients admitted with NF requiring surgery over a period      of 18 months.  The patients were randomized to two groups. In group A patients, the wounds were managed with conventional dressings and in group B patients, negative pressure wound therapy (NPWT) was applied. Serial assessment of both groups was done for four weeks. The parameters including size of wound, wound bed, granulation tissue formation, color, amount and odor of exudate, edema, frequency of dressing, re-debridement and pain were monitored and analysed.

Results: In our study, patients with NF wounds who underwent VAC therapy had earlier granulation tissue formation, resolution of infection and readiness for skin grafting. The frequency of dressing, requirement of re-debridement, resolution of edema, odor, skin maceration, inflammation around wound and pain significantly reduced in group B (VAC) when compared to conventional dressing group.

Conclusions: When compared to the conventional dressing on NF wound, application of VAC helped in early appearance of granulation tissue, significant reduction of inflammation, wound odor, exudate, need for re-debridement, frequency of dressing and pain. Thus, VAC dressing can be considered as a better option in the management of NF wounds.

Author Biographies

Birbal Kumar, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

R. S. Mohil, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

PROFESSOR AND CONSULTANT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Sajith K. Mohan, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Navnik Singh Bhardwaj, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Arush Pasricha, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Kashinath Singh, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Raghav Garg, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

Ratnakar Namdeo, Department of Surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India

SENIOR RESIDENT SURGEON,
GENERAL SURGERY DEPARTMENT
VARDHMAN MAHAVIR MEDICAL COLLEGE AND SAFDARJUNG HOSPITAL, NEW DELHI, INDIA

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Published

2021-11-26

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Original Research Articles