Clinical Study of Management of Wounds

Using Vacuum Assisted Dressings

By Dr. M. Srinath

Under The Guidance Dr. Abdul Ghader BM

-at Malla Reddy Narayana Multi-speciality Hospital
INTRODUCTION & NEED FOR STUDY:
“The process of wound healing is dynamic & intricate.
It involves quick cell movement & migration
sequence that helps in closure and repair”

The majority of conventional care comprises of

Necrotic tissue Debridement,
Hydrocolloid wound gels,
Dressings with enzyme-based debridement chemicals,
Infection control, treatment of local ulcers,
Mechanical unloading,
Blood glucose management,
Foot care education, and
Hyperbaric oxygen therapy.
INTRODUCTION & NEED FOR STUDY:
Anatomical or functional integrity is lost in a chronic
open wound that does not go through this series of
Events.

Debridement of all nonviable tissue in such injuries

may result in large soft-tissue defects that impede
primary closures, delayed primary closures,
or secondary intention healing.
 INTRODUCTION & NEED FOR STUDY:
In big wounds, negative pressure wound dressing may be a new technology that
shortens the period between debridement and definitive surgical closure by
promoting faster healing and accelerating granulation growth.
The utilization of regulated negative pressure levels has been demonstrated to
quicken debridement and encourage healing in a variety of wound types. it
seems that the ideal negative pressure level is around 125mm hg below ambient,
and research suggests that applying this in a cyclical manner—five minutes on,
two minutes off—maximizes its effectiveness. it is thought that the negative
pressure promotes blood flow, reduces localized edema, and helps remove
interstitial fluid.
thus, the amount of microorganisms in the tissue is reduced. furthermore, it is
believed that the production of proteins and matrix molecules is triggered by
mechanical deformation of cells, hence accelerating the rate of cell
proliferation.
 INTRODUCTION & NEED FOR STUDY:
The method is claimed to perform financially favorable when compared to
traditional treatments for the care of wounds that are difficult to heal, despite the
substantial expenses associated with it.

An open wound can be managed with negative pressure wound therapy

(NPWT), which involves subjecting the wound to either continuous or sporadic
subatmospheric pressure.

The effectiveness of vacuum assisted dressing in wound dressing has been

demonstrated, resulting in quicker wound healing and a shorter hospital stay.
REVIEW OF LITERATURE
Impaired wound healing is a serious health issue that primarily affects the elderly. It worsens social and
financial stress, prolongs pain and suffering, and prevents wounds from healing. Treatments for non-
healing wounds are expensive and time-consuming. Hence, advancements are made to speed up the healing
of wounds for the benefit of caregivers, patients, and healthcare professionals.

History of wound healing

The history of wound care goes back thousands of years, mirroring the ongoing efforts of people to treat
wounds and illnesses. For the treatment of wounds, ancient societies used poultices, herbal treatments, and
crude bandaging. The late 19th century saw a revolution in wound care as the concept of infection
management became increasingly clear, as demonstrated by the groundbreaking work of individuals such
as Joseph Lister. This historical background emphasizes how humans have continued to search for efficient
healing methods.

The Diverse Nature of Wounds:

There are many ways that injuries can appear, and each one has its own set of difficulties and factors to
take into account when managing the injury. This section explores the variety of wounds, including surgical
and trauma origins, acute and chronic categories, and particular disorders such as diabetic wounds and
pressure ulcers.
Understanding the Complexity for Effective Care
Generally speaking, wounds can be categorized as acute or chronic based on their
length and underlying causes. Cuts, burns, and abrasions are examples of abrupt
trauma or injury that result in acute wounds. They usually go through the stages of
healing within the anticipated time range. On the other hand, chronic wounds endure
for a long time and frequently do not go through the stages of normal healing. Chronic
wounds frequently have underlying medical illnesses like diabetes, vascular diseases,
or immune system dysfunctions linked to them.

Acute Vs. Chronic Wounds:

Surgical wounds are the result of scheduled medical procedures, and the type and
complexity of the surgery affects how the wound is managed. In order to promote the
best possible healing, the incision site needs to be closely watched for indications of
infection. The particular considerations in surgical wound care are influenced by
variables such the type of suture, wound closure methods, and the general health of the
patient.
Surgical Wounds:Traumatic Wounds
Accidents, wounds, or physical trauma can cause traumatic wounds. They can have a wide range of
characteristics, including crush injurie, lacerations, puncture wounds, and contusions. Damage to
underlying tissues, nerves, or blood vessels can result from traumatizing wounds; therefore, a
comprehensive evaluation and specialized treatment plans are necessary to address both obvious and
concealed damage.

Pressure Ulcers (Decubitus Ulcers):

Pressure ulcers, commonly known as bedsores or decubitus ulcers, primarily affect individuals with limited
mobility. These wounds develop due to prolonged pressure on specific body areas, often in conjunction
with friction and shear forces. Pressure ulcers are staged based on severity, with interventions aimed at
preventing progression, relieving pressure, and promoting healing in compromised skin and tissue.

Diabetic Ulcers:
Often referred to as bedsores or decubitus ulcers, pressure ulcers mainly afflict people who have restricted
movement. Prolonged pressure on particular body parts, frequently combined with friction and shear
forces, causes these wounds to form. The severity of a pressure ulcer determines its stage, and therapies are
designed to relieve pressure, stop the ulcer from getting worse, and encourage healing of the damaged skin
and tissue
Complexity in Wound Characteristics
In addition to the previously listed categories, wounds can have a variety of
features, such as differences in size, depth, and foreign body presence. The
intricacy of wound care is influenced by the extent of pollution, the volume of
exudate, and the possibility of subsequent infections. Comprehending the distinct
characteristics of every wound is crucial in customizing therapies that correspond
with the distinct requirements of the patient.

Multi factorial Considerations:

The variety of wounds emphasizes the significance of a patient-centered,
comprehensive approach. The course of wound healing is influenced by variables
like age, general health, nutritional status, and the existence of comorbidities.
Healthcare providers must take into account the complex nature of wounds while
creating customized treatment plans that take into account the patient's overall
health as well as any current wound-related concerns.
AIMS AND OBJECTIVES:
AIM

To study effectiveness of VACUUM ASSISTED DRESSING on selected type of

wounds including Diabetic foot ulcers, Traumatic ulcers, Venous ulcers, infected
wounds etc., and

To study effectiveness of VACUUM ASSISTED DRESSING on reducing

duration of hospital stay and economic burden on patient.
AIMS AND OBJECTIVES:
OBJECTIVES
To determine wound healing using VACUUM ASSISTED DRESSING on study patients who
showed no sign of healing through conventional dressing for 15 days

To determine the reduction in surface area of ulcers over a period of 15 days using VACUUM
ASSISTED DRESSING

To assess the time taken to achieve granulation tissue using VACUUM ASSISTED DRESSING

To determine the incidence of complete healing of the non healing ulcers

To study the effectiveness of VACUUM ASSISTED DRESSING in reducing the complications

of ulcers, and to study the complications associated with VACUUM ASSISTED DRESSING
MATERIALS AND METHODS:

STUDY POPULATION: Patients visiting the Tertiary Care Center at Malla

Reddy Naryana Multispeciality Hospital, Suraram, Hyderabad, which is
affiliated with Malla Reddy Medical College for Women

STUDY DESIGN: observational research conducted at the hospital. The

institutional ethical committee's approval will be obtained before the study
is started. The study has a time limit of February 2024 to February 2026.

STUDY PERIOD: 2024-2026

MATERIALS AND METHODS:

SAMPLE SIZE:
Patients attending Department of General Surgery O.P.D. during the Study
Period.
Sample size : 100;
Sampling method Simple Sampling Method

METHOD OF COLLECTION OF DATA:

Institutional Scientific Committee and Ethics Committee approval will be
obtained. Patients will be selected according to the inclusion criteria then Written
informed consent and Assent will be obtained from the patient. Data of the
patient will be collected in a pre-structural format, Analysed by computerized
software and statistical significance is derived by STUDENTS T TEST
MATERIALS AND METHODS:

INCLUSION CRITERIA:-
Diabetic foot ulcer
Traumatic ulcer
Pressure ulcer
Venous ulcer
Burns
Fasciotomy wounds
EXCLUSION CRITERIA:-
Cancerous ulcers
Osteomyelitis
Ulcers resulting from electrical chemical radiation burn
Pregnancy
Lactating mother
Age less than 20yrs and more than 70 yrs

Every patient will undergo clinical examination other necessary investigations in

Mallareddy Medical College for Women, following a thorough clinical check-up
Information collection data points
Type of Wound
Categorizing the wound based on its origin, such as surgical, traumatic,
pressure ulcer, diabetic ulcer, or other.
Size
Measuring the length, width, and depth of the wounds
Shape
Describing the shape of the wound, whether it is irregular, linear, circular, or
another configuration.
Edges
Evaluating the characteristics of the wound edges, including whether they
are well-defined, undermined, or irregular.
Color of Wound Bed
Assessing the color of the wound bed, noting any signs of healthy
granulation tissue, necrosis, slough, or infection.
Information collection data points
Exudating
Describing the type and amount of wound exudate (e.g., serous,
serosanguinous, purulent) and note if the wound is dry or excessively moist.
Tissue Viability
Evaluating the viability of the surrounding tissues, including signs of
inflammation, erythema, or induration.
Undermining/Tunneling
Check for any undermining or tunneling around the wound, noting the
depth and direction if present.
Pain Assessment
Documenting the patient's reported pain associated with the wound, using a
pain scale if applicable.
Odor
If applicable, note any characteristic odor emanating from the wound.
Information collection data points
Infection Signs
Evaluating for signs of infection, such as increased redness, warmth,
swelling, or the presence of purulent discharge.
Surrounding Skin
Assessing the condition of the skin surrounding the wound, including signs
of maceration, ecchymosis, or dermatitis.
Patient History
Considering the patient's medical history, including any chronic conditions
or medications that might influence wound healing.
Photographic Documentation:
Using photographs, with patient consent, to visually capture the
characteristics of the wound at different stages.
Ethics committee clearance
Institutional Scientific Committee and Ethics Committee approval will be
DATA ANALYSIS
The collected data will be tabulated. Statistical analysis will be computerized.

IMPLICATION OF THE STUDY

To determine the efficacy of vacuum-assisted dressing by taking all the physical
parameters of ulcer into consideration such as ulcer size, margins, granulation
tissue, discharge etc.,
Thank You

Dr. M. Srinath