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The Usefulness of Topical Negative Pressure (TNP) As a Supporting Method for the Surgical Treatment of Venous Ulcers with the use of Middle-Split Thickness Skin Graft

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Zieliński M., Pukacki F., Oszkinis G., Gabriel M., Waliszewski K., Majewski W.

Polish Journal of Surgery

2008

vol. 80

issue 3

124-131

The most effective method of treatment for venous ulcers resistant to conservative therapy is operation.The surgical procedure consists of resection of the entire ulceration followed by perforated middle-split thickness skin graft transplant. Postoperative treatment requires both long term elevation of the patient's leg and frequent dressing changing.The aim of the study was to assesses the effectiveness of TNP as a method supporting surgical treatment.Material and methods. From 2004 to 2006 in the Poznań Clinic of General and Vascular Surgery of Medical University, 25 patients (16 women and 9 men) were treated for venous ulcers resistant to conservative treatment. The patients' ages varied from 50 to 82 years (average: 69), and the time of ulceration presence ranged from 6 months to 6 years (average: 2 years and 5 months). Patients were divided into two groups: all patients in group I (n=14) underwent surgical treatment with the use of middle split thickness skin grafting, whereas all patients in group II (n=11) underwent surgical treatment with support of TNP - VAC® Subsequent parameters, including the time of hospitalization, time and effectiveness of skin graft healing, and patient's subjective comfort of the therapy, were analyzed.Results. The average hospitalization time was significantly shorter in group II than group I (18 vs 24 days, p<0.0005). The average healing time in group II was significantly shorter than that in group I (31 vs 42 days, p<0.00002). Additional skin grafting was necessary in four cases from group I but none from group II. Subjective therapy comfort was higher among patients from group II than group I.Conclusions. TNP is a useful method supporting the surgical treatment of venous ulcers that are resistant to conservative treatment.

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1 Polish Journal of Surgery

1 2008

1 Gabriel M.

1 Majewski W.

1 Oszkinis G.

1 Pukacki F.

1 Waliszewski K.

1 Zieliński M.

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The Usefulness of Topical Negative Pressure (TNP) As a Supporting Method for the Surgical Treatment of Venous Ulcers with the use of Middle-Split Thickness Skin Graft