EXPERIENCE WITH VACUUM-ASSISTED CLOSURE DEVICE IN THE MANAGEMENT OF BENIGN CHRONIC LEG ULCERS
*Opara KO.
** Nwagbara IC
* 1)Plastic Surgery Division,
Department of Surgery,
Imo State University Teaching Hospital, Orlu, Imo State.
E-mail : kin2para@yahoo.co.uk
**2)Orthopaedic Surgery Division,
Department of Surgery,
Imo State University Teaching Hospital, Orlu, Imo State.
Correspondence: Opara KO.
Conflict of Interest: None
Grant support: None
OFOEGBU RO.
Department of Surgery, University of Benin
Benin City, Nigeria
E-Mail: ofoegbuor@yahoo.com
ABSTRACT
Background: Chronic leg ulcers are commonly encountered in clinical practice. They often last several months to years, with a negative social and economic impact on the patient. Rapidly effective modalities of treatment are therefore to be desired.
Vacuum-Assisted-Closure (VAC) device in the management of benign chronic ulcers has been reported in the literature; however, there are limited reports on its use in the West African sub-region.
Aim: To assess the efficacy of VAC therapy in the management of chronic leg ulcers in our patients.
Patients and Method: Case records of patients with chronic leg ulcers presenting at the plastic surgery unit of Imo State University Teaching Hospital, who were managed using the Vacuum Assisted Closure (VAC) device were reviewed. The period of study was from July 2008 to June 2010 (24 months). Data obtained were analyzed using descriptive statistics.
Results: Forty one patients with 52 leg ulcers were managed in the period under review. M:F = 3:1 Their ages ranged from 13 to 82 years with a mean age of 43years. Sickle cell ulcers and Post traumatic ulcers were commoner in the young adults, while the vascular ulcers were commoner in the middle aged and elderly. Patients with sickle cell and vascular ulcers were more likely to have multiple ulcers. The sickle cell and venous ulcers had the longest duration but most rapid response to VAC therapy. The arterial ulcers showed poor response. Skin grafting after VAC therapy was excellent in all patients.
Conclusion: VAC is a useful adjunct in the management of benign chronic leg ulcers. It is exceptionally effective in venous, sickle cell and post traumatic ulcers, which are quite common in this environment.Key words: Vacuum-assisted-closure, Chronic leg ulcer, Good outcome.