Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device: A review

Mark L. Venturi, Christopher E. Attinger, Ali N. Mesbahi, Christopher L. Hess, Katherine Lamond

Research output: Contribution to journalArticle

Abstract

The use of sub-atmospheric pressure dressings, available commercially as the vacuum-assisted closure (VAC) device, has been shown to be an effective way to accelerate healing of various wounds. The optimal sub-atmospheric pressure for wound healing appears to be approximately 125mm Hg utilizing an alternating pressure cycle of 5 minutes of suction followed by 2 minutes off suction. Animal studies have demonstrated that this technique optimizes blood flow, decreases local tissue edema, and removes excessive fluid from the wound bed. These physiologic changes facilitate the removal of bacteria from the wound. Additionally, the cyclical application of sub-atmospheric pressure alters the cytoskeleton of the cells in the wound bed, triggering a cascade of intracellular signals that increases the rate of cell division and subsequent formation of granulation tissue. The combination of these mechanisms makes the VAC device an extremely versatile tool in the armamentarium of wound healing. This is evident in the VAC device's wide range of clinical applications, including treatment of infected surgical wounds, traumatic wounds, pressure ulcers, wounds with exposed bone and hardware, diabetic foot ulcers, and venous stasis ulcers. VAC has also proven useful in reconstruction of wounds by allowing elective planning of the definitive reconstructive surgery without jeopardizing the wound or outcome. Furthermore, VAC has significantly increased the skin graft success rate when used as a bolster over the freshly skin-grafted wound. VAC is generally well tolerated and, with few contraindications or complications, is fast becoming a mainstay of current wound care.

Original languageEnglish (US)
Pages (from-to)185-194
Number of pages10
JournalAmerican Journal of Clinical Dermatology
Volume6
Issue number3
DOIs
StatePublished - 2005
Externally publishedYes

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Negative-Pressure Wound Therapy
Equipment and Supplies
Wounds and Injuries
Atmospheric Pressure
Wound Healing
Suction
Reconstructive Surgical Procedures
Varicose Ulcer
Skin
Diabetic Foot
Granulation Tissue
Pressure Ulcer
Bandages
Cytoskeleton
Cell Division
Edema
Bacteria
Transplants
Pressure
Bone and Bones

ASJC Scopus subject areas

  • Dermatology

Cite this

Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device : A review. / Venturi, Mark L.; Attinger, Christopher E.; Mesbahi, Ali N.; Hess, Christopher L.; Lamond, Katherine.

In: American Journal of Clinical Dermatology, Vol. 6, No. 3, 2005, p. 185-194.

Research output: Contribution to journalArticle

Venturi, Mark L. ; Attinger, Christopher E. ; Mesbahi, Ali N. ; Hess, Christopher L. ; Lamond, Katherine. / Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device : A review. In: American Journal of Clinical Dermatology. 2005 ; Vol. 6, No. 3. pp. 185-194.
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