Abstract
Background: Negative pressure wound therapy (NPWT) is an alternative to standard treatment of acute wounds (such as traumatic or post-operative wounds) but also in that of chronic wounds (such as ulcers or stage 3 and 4 pressure ulcers). However, the exorbitant cost of VAC (vaccum assisted closure) devices for our limited resources health facilities, and their unavailability led us to opt for a "low cost" solution using wall suction and disposable materials readily available in all surgical departments. Materials and methods: After surgical debridement in 3 patients with both acute and chronic lesions evolving in septic environment, we replaced polyurethane foam by that from surgical scrub brushes, the tubing and its suction port by nasogastric tube, the hydrocolloid for the protection of wound edges by tulle gras (vaseline gauze), the adhesive film ensuring sealing by an incise drape, and the therapy unit by wall suction and exudates collection bottle. We cut up the foam to make it correspond to the wound, in size and depth, and then, using straight forceps, we create a tunnel in it, large enough to allow the introduction of the nasogastric tube. We then carefully place the foam in the wound. After that, we proceed to application of incise drape to cover foam dressing and connect the end of the probe to wall suction system via suction bottle. Therapy is initiated by setting vacuum gauge to a continuously delivered negative pressure of -125 mmHg.Results: The size of all wounds reduced considerably and rapidly with the installation of budding granulation tissue which appeared as early as the first dressing change enabling subsequently the best possible conditions for directed healing or coverage procedures (skin graft or flaps). The healing was obtained for all our patients.Conclusions: In this "low cost" NPWT, the negative pressure produced by wall vacuum promotes effective management of acute and chronic wounds, including complex ones, by rapidly "producing" good quality granulation leading to healing, while reducing the cost of therapy, the number of dressings and the length of hospital stay.Trial registration: Retrospectively registered
A A simple and low-cost technique of creating a Negative Pressure Wound Therapy (NPWT) machine on the example of a severe phlegmon of lower limb in lower socio-economic area.