What You Need to Know About Vacuum-Assisted Wound Closure (VAC)
Vacuum-assisted closure (VAC) is a method of decreasing air pressure around a wound to assist the healing. It’s also referred to as negative pressure wound therapy.
During a VAC procedure, a healthcare professional applies a foam bandage over an open wound, and a vacuum pump creates negative pressure around the wound. This means the pressure over the wound is lower than the pressure in the atmosphere. The pressure pulls the edges of the wound together.
Most clinical trials on people and animals have found that VAC for wound healing is equally or more effective than conventional wound closing techniques. VAC therapy can help to heal in several ways, such as reducing swelling, stimulating the growth of new tissue, and preventing infections.
In this article, we’ll examine how VAC helps wound healing. We’ll also look at the benefits of VAC therapy and answer some common questions you may have about this technique.
Who needs to use a wound VAC?
VAC gained popularity as a wound treatment option throughout the 1990s and 2000s. This type of wound treatment might be suitable for people with the following conditions:
A retrospective review looked at the effectiveness of VAC for children with burn wounds or soft-tissue trauma.
The researchers found a link between third-degree burn wound size and the number of VACs received. They concluded VAC could be a safe and effective option that doesn’t cause excessive discomfort in children.
Cesarean delivery (C-section)
VAC may help prevent infections after giving birth via cesarean delivery (more commonly known as a C-section).
A review of studies looked at the effects of VAC in women with obesity who were at high risk for developing wound complications. Overall, the researchers found that VAC seemed to be able to decrease the number of infections and complications.
Traumatic and surgical wounds
VAC might be useful in the healing of traumatic injuries and postoperative wounds.
One review concluded that VAC has the potential to reduce infections after surgery. It also found that VAC may be more cost-effective than traditional treatment options when hospital costs are taken into account.
Pressure ulcers are sore skin spots caused by continuous pressure. VAC may be a suitable treatment option in some cases.
One study looked at the use of VAC to heal a patient’s ulcer. Using VAC healed the ulcer in 6 weeks at half the cost of reconstructive surgery.
Types of wounds not suitable for VAC
VAC is suitable for a wide range of wounds. However, some types of wounds aren’t suitable for VAC. These include:
- wounds near joints that may reopen with limb movement
- cancer tissue
- infected wounds
- exposed organs or blood vessels
- fragile skin
- areas with poor blood flow
How wound VAC therapy works
A VAC therapy system includes a vacuum pump, a special bandage, a canister to collect fluid, and tubing.
A healthcare provider first fits a layer of foam dressing over the wound, which is sealed with a thin layer of film. The film has an opening that rubber tubing can fit through to connect to a vacuum pump.
Once connected, the vacuum pump can remove fluids and infections from the wound while helping to pull the edges of the wound together.
A person undergoing VAC therapy wears the device for close to 24 hours per day while they’re healing. The optimal level of negative pressure seems to be about 125 mm Hg for a duration of 5 minutes on and 2 minutes off.
Here a wound vacuum is attached to a wound that goes down to the muscular layer. The foam and negative pressure promote wound healing.
Does using a wound VAC cause pain?
When VAC therapy starts, you may feel stretching and pulling around your wound. VAC therapy shouldn’t hurt, and if it does it can indicate a complication.
Many people experience discomfort when VAC bandages are changed. In some cases, a medical professional might administer pain medication 30 to 60 minutes before changing the bandages.
Wound VAC benefits
Wound VAC has the potential to be a cost-effective treatment option to help treat various types of wounds. Potential benefits include:
- decreased swelling and inflammation
- decreased risk of bacterial infection
- increased blood flow to the wound
- decreased overall discomfort
- less changing of wound dressings compared with other treatments
- gentle pulling together of the wound’s edges
Potential wound VAC therapy complications
VAC therapy is generally safe, but complications can occur. One study presented two cases of people who developed sepsis and hemorrhage after having VAC therapy for burns.
Other potential complications include bleeding, bacterial infections, and a lack of wound healing, which can lead to more invasive treatment methods.
Some people undergoing VAC therapy may develop an enteric fistula, a condition in which the skin and intestinal tract become abnormally connected.
Another possible complication is macerated skin, which is the softening and breaking of skin around the wound due to moisture.
How much does it cost?
One retrospective analysis looked at the treatment costs of VAC at the University of Chicago Medical Center between 1999 and 2014. The researchers estimated that the average price of VAC therapy was $111.18 per day.
Most insurance policies, as well as Medicare, cover at least part of the cost of VAC therapy.
Where is wound VAC therapy performed?
VAC therapy can be performed in a doctor’s office or in a medical facility.
You may also be able to have VAC therapy at home depending on the size and location of a wound. Your surgeon will determine if it’s suitable for you to continue VAC therapy at home.
Wound VAC therapy duration
The length of time the procedure takes varies widely on the size and location of your wound. Your doctor should be able to give you an estimate for how long you’ll undergo VAC therapy based on your wound.
Living with a wound VAC
Living with a wound VAC can cause challenges to your daily life, but understanding what you can and can’t do while undergoing treatment can make treatment easier.
Can you shower with a wound VAC?
It’s possible to shower with a wound VAC by disconnecting the VAC system. (Note that you shouldn’t leave your VAC system unplugged for more than 2 hours per day.)
It’s not a good idea to take a bath with a wound VAC, however, because sitting in water can expose your wound to bacterial infections.
Wound VAC dressing change frequency
VAC bandages should be changed two to three times a week. If your wound gets infected, the bandages may need to change more often.
Who changes the VAC dressing?
Usually, a healthcare provider will change your bandages. In some cases, a family member or a caregiver can be trained to change your dressing.
When to discontinue wound VAC use
In rare cases, VAC can lead to bleeding, bacterial infections, or other serious complications.
If you have any of the following symptoms, call your doctor immediately.
- fever higher than 102°F (39°C )
- bleeding around the wound
- rash around your wound
- nausea or vomiting
- sore throat
VAC therapy uses pressure to help close wounds and increase healing. It can be used for a variety of wounds, such as those caused by burns, cesarean deliveries, and traumatic injuries.
You generally don’t need to prepare in advance for VAC.
If you’re undergoing VAC therapy, ask your doctor any specific questions you may have about your wound healing.
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