ĐÁNH GIÁ HIỆU QUẢ PHƯƠNG PHÁP ÁP LỰC ÂM ĐÓNG DA THÌ ĐẦU ĐƯỜNG MỔ SAU PHẪU THUẬT CHI DƯỚI

Abstract

Background: After being recognized for success in treating many types of wounds caused by open fractures, large skin grafts, ischemia or infection ... negative pressure therapy supports wound closure, continued successful with good results, helped for primary wound closing, which have risk of skin necrosis or surgical wound dehiscence. In Vietnam, there are many reports about using of negative pressure therapy on common wounds but there is no study have been used it on primary wound closure. Objective: Evaluation of the effectiveness by using negative pressure in the primary skin closure method after lower limb surgery. Method and Materials: Observational Prospective Studies, we study on 33 patients aged 18 years and older who received treatment for close fracture, open fracture and severe soft tissue injuries of the lower extremities at Cho Ray Hospital from December 2022 to November 2023. Results: There are no cases of hematoma, seroma, hemorrhage, superficial or deep wound infection. Postoperative pain score according to the NRS (Numerical Pain Rating) scale does not record any cases of pain >3/10 scores. In 2/33 (6.1%) cases, wound suturing becomes wide separation than removing VAC system in the next day. Between suture, the skin space is 5-10mm. This situation does not last long and responds well with antibiotics, anti-inflammatories, and conventional wound dressings. Both cases do not need surgery and will healing many days later. There is 1/33 (3.03%) cases of blisters after using VAC system, the blisters are scattered under adhesive film covers and around the outside it. There is 1/33 (3.03%) cases epidermal peeling after VAC removal, this patient is  re-surgery twice after that. 29/33 cases does not record any complication. The average time in hospital is 6.21 ± 2.13 days, the smallest is 3 days, the largest is 12 days. The average time until complete wound healing is 14.27 ± 2.75 days, the smallest is 10 days, the largest is 21 days. Conclusions: Applying negative pressure therapy for primary skin closure after lower limb surgery is a safe technique with low rate of complications during and after surgery. The wound healing rate is high, it does not increase treatment costs but reduces the number of days in the hospital.