engleski

Vacumed- Intermittent Vacuum Therapy (IVT) in chronic wound healing

Goal: To evaluate effectiveness of Intermittent Vacuum Therapy (IVT) on chronic wound healing, depending on etiology and compared to standard principles of chronic wound treatment. Previous studies have shown that IVT, with its alternating action of positive and negative pressure on the lower part of the body, improves blood and lymph circulation, capillary function and tissue oxygenation. Vacumed IVT has also been demonstrated to increase the mobility of patients, by reducing edema and pain, which is very important in the treatment of vascular patients and patients with chronic wounds. Methods: We retrospectively analyzed medical records of 97 vascular patients with chronic wounds of different etiologies (ischemic, hypostatic, neuropathic and mixed), treated at UHC Zagreb in the period from 2019 - 2022. Vacumed IVT was applied in 47 patients, while 50 patients were not subjected to Vacumed IVT. Vacumed IVT sessions were performed 2-3 times per week, with a session duration of 30-40 minutes, depending on the protocol and etiology of the chronic wound. In all patients, local treatment of the wound was carried out according to standard principles. Continuous variables (wound size, age and ankle- brachial index – ABI) were tested for normality and analyzed by Student’s t-test or Mann-Whitney U test, depending on the results of normality tests. Categorical (discrete) variables (etiology, gender, mobility, intensity of pain, presence of edema and infection, amputation, healing completeness) were analyzed by chi-square or Fisher’s exact test. Results: Complete healing was significantly associated with the application of Vacumed IVT (Fisher’s exact test ; p=0.0352), as it was achieved in 34 out of 47 (72.3%) IVT treated patients, and only in 26 out of 50 patients (52%) in control group achieved. Patients in whom the wounds completely healed were on average younger (68.13 vs 70.36 years of age ; p=0.369) and had better ABI (0.79 vs 0.68 ; p=0.36693), although the differences were not statistically significant. They also had significantly shorter history of chronic wound (11.61 vs 19.75 ; p=0.0239), smaller wounds (21.54 vs 38.25 ; p=0.0188) and less pain (VAS score 3.96 vs 6.48 ; p=0.00219). The application of Vacumed IVT was also significantly associated with less amputations compared with untreated group (0/4 major amputations, 1/7 minor amputations, and 45/39 amputation-free patients - Fisher’s exact test, p = 0.0104). In addition, mobility was also better (full mobility 45/39, partial mobility 1/9 patients, immobility 0/2 patients) in Vacumed IVT treated and untreated groups, respectively - Fisher’s exact test, p = 0. 00603). Conclusion: Considering our patients, Vacumed IVT was associated with significantly better wound healing, better mobility and less frequent amputations (both major and minor). Vacumed IVT acts on all stages of wound healing regardless of chronic wound etiology. The reduction of pain and secretion reduces the frequency of wound dressing, which improves the quality of life and mobility of patients, especially patients with PAD. Vacumed IVT is therefore a powerful tool in treating patients with chronic wounds with wide spectrum of usage and especially in vascular patients.

chronic wounds, Vacumed-IVT, wound healing

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