Experience of using vacuum therapy in the burn department

Abstract

Relevance. Indications, application techniques and contraindications for the use of vacuum therapy in surgery and orthopedics are formulated in clinical guidelines and are generally available. Indications for the use of a vacuum in patients with severe burns are scattered and depend on personal experience and preferences of the medical staff, and not on objective reasons.Intention. To analyze the results of using Negative Pressure Wound Therapy (NPWT) in patients of burn departments.Methodology. The study included 56 patients treated with local negative pressure in the Department of thermal injuries of the Saint-Petersburg institute of emergency care named after I.I. Dzhanelidze in 2017–2020. Statistical data processing was performed using Microsoft Office Excel 2007 and IBM SPSS 20.0 using descriptive and non-parametric statistics.Results and their Discussion. The frequency of using VAC-therapy in patients with burn injuries was 0.8 % (56 of 6764). The most common reasons for hospitalization of patients were contact injuries – 20 (36 %) and flame burns – 18 (32 %). The main indications for NPWT were stimulation of granulation formation – 21 (38 %), control of wound infection – 20 (36 %), and temporary wound closure after early excisions or atypical amputations – 11 (20 %). The main contraindications to the use of the method were cognitive disorders or impaired consciousness. The primary complication was the depressurization of the dressings, which we encountered in 9 cases (16 %). The expected results of vacuum therapy were achieved in 49 patients (88 %).Conclusion. Local negative pressure is relatively rarely used in burn treatment. A positive effect from the use of NPWT can be expected in the control of wound infections and in the preparation of wounds for skin grafting. The prospects for the introduction of the method can be considered its application in the treatment of partial-thickness burns and additional fixation of skin grafts. To objectify the choice of modes and duration of vacuum therapy in burned patients, it is necessary to conduct further multicenter studies with the preparation of clinical guidelines.