Vacuum Assisted Closure (VAC) therapy, also known as Negative Pressure Wound Therapy (NPWT), promotes healing through sub-atmospheric pressure, improving wound depth, accelerating healing, and reducing complications. It is effective for various wound types including diabetic and ischemic ulcers, though it may increase bacterial counts. The therapy utilizes sterile dressings and a vacuum system, with options for portable devices and fluid instillation.

1. VACUUM ASSISTED CLOSURE
(VAC) THERAPY
UG BATCH- 2017
Date-10/9/21
Dr. Ankita Singh
Assistant Professor
Department of Surgery

2. Introduction
• Also known as NPWT
– Negative pressure- assisted wound therapy
• Principle:
– Creation of sub-atmospheric / negative pressure
over a wound surface promotes healing
• Pressure: -70 to -200 mmHg (-125)
• Intermittent/ continuous

3. Mechanisms
• Reduces fluid in the interstitial space
– reduces oedema
• Removal of wound exudate
• Keeps wound moist
• Increases local blood flow
• Increases the cell proliferation
• Increases protein matrix synthesis

4. Mechanisms..
• Stimulates granulation tissue
• Increases capillary caliber
• Stimulates endothelial proliferation
– Angiogenesis
• Microstrains & macrostrains:
– 3 D stresswithin cells & across whole area of
wound respectively
– Increase cellular proliferation & higher
microvessel density

5. Mechanisms..
• Alters wound fluid composition
– Removes deleterious proteinases & inflammatory
cytokines
• e.g., MMP-1,2,9, IL-1β & TNF-α
– Up-regulation of
• VEGF, TGF-β1, TIMP-1
– Significantly increases growth factors, decrease
inflammatory cytokines & normalize MMP activity

6. Advantages
• Significant improvement in wound depth/size
• Accelerated wound healing
• Accelerated wound bed preparation &
granulation tissue formation
• Improved rated of graft take
• Decreased drainage time for acute wounds
• Reduced complications
• Increased patient survival
• Decreased cost (cost effective)

7. Issues
• Shown to increase bacterial counts, despite
increased wound healing
• Availability

8. Indications
• Closure of wounds, wherein primary closure is
not possible
• Diabetic wounds, ischemic ulcers, complex
surgical or trauma wounds with/ without
contamination & burns
– Acute, subacute, chronic wounds

9. Make & Model- conventional
• Composition
– Sterile filler- foam/ gauze dressing
– Sterile adhesive film
– Drainage tubing- perforated end
– Collecting canister
– Suction system (vacuum pump) with display
– Battery/charging system/ electricity

14. Modifications
• NPWT/VAC device with instillation
– Irrigation by sterile fluids
– Removal of thick exudate & infectious products
• Portable VAC device
– Suitable for outpatient treatment

18. How to apply VAC

19. Thank you