Case report                                                                                                  UDC: 616-001-089.84                                                                                                          doi:10.5633/amm.2015.0114

  

USE OF VACUUM-ASSISTED CLOSURE (VAC) IN COMPLICATED
PERINEAL WOUNDS: ANALYSIS OF CASES

 Blaž Trotovšek¹, Danijela Semenič²

  

University Medical Centre, Department of Abdominal Surgery, Ljubljana, Slovenia¹

University Medical Centre, Department of Surgical Infections, Ljubljana, Slovenia²

 

 

                      Contact: Blaž Trotovšek
                      Department of Abdominal Surgery
                      University Medical Centre
                      Zaloška 7, 1000 Ljubljana, Slovenia
                      E-mail: blaz.trotovsek@kclj.si

 

Treatment of perineal wounds has been one of the challenges of surgery since its inception. Vacuum-assisted closure provides a new option that can be used in concert with a wide variety of standard existing surgical techniques. It was originally developed for treatment of chronic wounds in patients with diabetes. It has rapidly evolved into a widely accepted treatment also for acute, contaminated and complicated wounds from failed operations. User-friendliness of the technique and a high rate of success have promoted its use in all surgical specialties. One of the greatest achievements of modified technique is undoubtedly improvement in the treatment of open abdomen. Use of vacuum-assisted closure techniques in large contaminated abdominal and perineal wounds even in the presence of the artificial material like meshes has gained widespread acceptance among surgeons. Creative surgeons continue to regularly adapt the technique to difficult clinical problems. Perineal wounds present a special challenge. The vacuum-assisted closure device allows earlier wound closure, early skin grafting and hospital discharge. Its use in the perineum presents a challenge, but with proper application, even the most complex perineal wounds can be healed. We present four cases of complex perineal wounds in which the vacuum-assisted closure device was used. In experienced surgical hands, it greatly enhances the scope and safety of wound treatment. Acta Medica Medianae 2015;54(1):81-86.

 

Key words: perineal wounds, vacuum-assisted closure, negative pressure wound therapy, wound healing, surgical technique