v.a.c. therapy in bulgaria initial experience
TRANSCRIPT
V.A.C. THERAPY IN GENERAL SURGERY – INITIAL EXPERIENCE
V. Mutafchiyski
Military Medical Academy – Sofia, Bulgaria
Introduction
Since its introduction, V.A.C.® Therapy has
changed the way wounds are healed
V.A.C. Therapy has been selected as the
treatment of choice for more
than 3,000,000 people worldwide
The V.A.C. Therapy System
is comprised of three essential components
that actively work together to help promote
wound healing through granulation tissue formation:
1. V.A.C. Therapy Unit - provides intermittent and continuous therapy with integrated patient safety features
2. Sensa T.R.A.C. Technology - regulates pressure at the wound site to provide accurate delivery of prescribed therapy settings
3. V.A.C. GranuFoamTM Dressings - help provide the necessary mechanisms to promote granulation tissue formation
V.A.C. Therapy - Mechanisms of Action
Wound Healing Barrier V.A.C. Therapy Mechanism
Excess bacterial burden Removes infectious materials
Inadequate protection against infection Provides protected wound healing environment
Excess exudates Removes exudates
Excess edema (interstitial fluid) Reduces edema (interstitial fluid)
Absence of moisture Provides a moist wound healing environment
Lack of adequate blood flow Promotes perfusion
Lack of granulation tissue formation Removes barriers to cell migration and proliferation
Indications Traumatic wounds Complicated wounds High risk wounds Chronic and non-healing wounds Diabetic wounds Decubitus Fistulas Skin grafts, burns
Clinical case 1 36 years old soldier injured in Kandahar
(Afghanistan) Penetrating wound in left femoral region with
damage of v.saphena magna sin, scrotum, fracture of the pubic bone and left gluteus
Clinical case 1
Clinical case 1
Interval between procedures
48 hs
Pressure GranuFoam continuous-125 mmHg
Number of procedures
15
Clinical case 1
Clinical case 1
Clinical case 1
Clinical case 2
26 years old female
Penetrating wound of the abdomen
Injury of the colon, duodenum, stomach, IVC,
right kidney
Severe peritonitis with multiple revisions of the
abdomen
Suppuration of the wound
Clinical case 2Dinamic closure of the abdomen
Clinical case 2
Interval of procedures
48 hrs
Pressure GranuFoam continuous-125 mmHg
Number of procedures
2
Clinical case 3
34 years old male
Gun shot injury in the sacral region
Injury of sacral bone, rectum,
bladder, small intestine, left urether
Hemorrhagic shock
Clinical case 3
Clinical case 3
Clinical case 3
… 48 hours later …
Clinical case 3
Clinical case 3
Clinical case 3
Clinical case 3
Clinical case 3
48 hours later …
Clinical case 3
42 years old male Crush syndrome Pelvic fracture Hemorrhagic shock Angiographic embolization
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 4
Clinical case 565 years old femaleChronic diabetic wound (5 years)Failure of CONV therapy
Clinical case 5
Clinical case 5
Clinical case 6
22 years old male
Crohn’s disease
Abscess of the right psoas muscle
penetrating into femoral canal
Right hemicolectomy Evacuation of the
abscess Contra-incition
Clinical case 6
Clinical case 6Interval between
procedures 48 hrs
Pressure GranuFoam continuous-125 mmHg
Number of procedures - 2
Clinical case 7
38 years old female
Diasthasis of the abdominal rectal muscles
Three consecutive child- births
Clinical case 7
Clinical case 7
Clinical case 7
Clinical case 8
55 years old male24 days after liver transplantation for HBV
Clinical case 8
Clinical case 8
Clinical case 9Pancreatic cancerMechanic jaundice Purulent cholangitisPostoperative suppuration of the wound
Clinical case 10
High risk wounds
Conclusion
Treatment with the VAC system:
effective in complicated traumatic patient
has a low infection recurrence rate
Improved quality of life
Has a short therapy duration and yields a high
cost efficacy
Thank you