Publication: Vacuum-assisted closure (VAC) therapy in the management of wound infection following renal transplantation
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Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Objectives: Wound infection in the setting of immunosuppressed state such as renal transplantation (RT) causes
significant morbidity from sepsis, prolongs hospital stay and is expensive. Vacuum-assisted closure (VAC)
therapy is a new technique of management of wound based on the principle of application of controlled negative
pressure. The aim of this study was to assess the efficacy of VAC therapy in the management of wound
infection following RT.
Materials and methods: This is a prospective study of a cohort of 180 consecutive RTs performed over a
period of 4 years, where the data were retrieved from a prospectively maintained computerised database and
case-notes.
Results: 9 of 180 (5%) patients developed wound infection following RT which led to cavitations and
dehiscence with copious discharge, and refused to heal with conventional treatment. All 9 cases were treated
with VAC therapy. The VAC system was removed after a median of 9 (range 3-30) days when discharge from
the wound ceased. Four patients were discharged home with portable VAC device and managed on an outpatient
basis, where the system was removed after a median 5.5 (range 3-7) days. The median hospital stay after
initiation of VAC therapy was significantly shorter (5, range 2-12 days) than on conventional treatment prior to
VAC therapy (11, range, 5-20 days) (p=0.003). Complete healing was achieved in all cases.
Conclusions: The use of VAC therapy is an effective and safe adjunct to conventional and established treatment
modalities for the management of wound infection and dehiscence following RT.
Key words: Renal transplantation, wound infection, vacuum-assisted closure therapy
Description
Shrestha BM, Nathan VC, Delbridge MS, Parker K, Throssell D, McKane WS, Karim MS, Raftery ATSheffield Kidney Institute, Northern General Hospital, Sheffield, UK