According to a study at Wake Forest University Baptist Medical Center, use of the Vacuum Assisted Closure (V.A.C®) device on second-degree hand burns appears to minimize wound progression and decrease swelling.
Plastic surgeon Joseph A. Molnar, M.D., Ph.D., F.A.C.S., presented the interim results of the study at the American Burn Association’s 36th Annual meeting in Vancouver, Canada, March 24 - 26.
The results showed significant improvement at three days and even greater improvement at five days.
“Present management of the burn wound is primarily directed at preventing infection but does little to prevent burn wound progression or the inflammatory response,” said Molnar. “This study was designed to evaluate the effect of negative pressure on burn wound progression, edema and hand function when applied to acutely burned hands.”
The Wake Forest University Baptist Medical Center Burn Unit is one of only two burn centers in North Carolina. It provides acute and chronic burn care in the western part of the state.
The V.A.C. device uses suction to help uniformly draw wounds closed and reduce swelling and infection by removing fluids at the site of the injury while creating a moist wound healing environment. It was invented by Louis C. Argenta, M.D., chairman of the Plastic and Reconstructive Surgery Department, and Michael J. Morykwas, Ph.D., Associate Professor of Plastic and Reconstructive Surgery at Wake Forest Baptist.
The study design was multi-center and Web-based. Sites included the University of Washington, Seattle, the University of Florida, Gainesville, and academic medical centers in Vancouver and Edmonton, Canada, Augusta, Ga., Portland, Ore., and Mobile, Ala.
A total of 23 adult patients were evaluated at this stage in the study. The V.A.C. device was applied to the burned hands for 48 hours. During the healing process, the hands were observed for signs of reduced swelling, healing, and increased functionality.
As a Web-based study, Molnar was able to monitor each patient in the study within 24 hours after the patient was enrolled to ensure consistency. Digital photography was used to accurately record the healing process, clinically estimate the depth of the burn, and transmit the photographs over the Internet.
“This method of standardized digital photography allows for clinical evaluation and quantification of wound size in a consistent manner in a Web-based multi-center trial of burn care,” said Molnar. “This technique could readily facilitate future prospective multi-center studies.”
The biggest use of the V.A.C. device is at Wake Forest Baptist’s Center for Comprehensive Wound Care, where physicians evaluate, diagnose and treat acute and chronic wounds. They use innovative techniques including the V.A.C. device, cultured skin therapies, reconstructive and micro vascular surgeries and numerous other special resources that provide patients with individualized treatment plans.
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