![]() ![]() VAC GranuFoam dressing - Black is hydrophobic, and its open-pore nature (400-600 microns) provides a uniform application of negative pressure at the wound site. Four-hundred to 600 micron-reticulated pores help distribute pressure through the wound bed . The VAC canister collects the wound exudate. It provides direct and complete contact with the wound bed. VAC GranuFoam dressings contract under negative pressure. The VAC drape helps in providing a wound healing environment. Figure 3 shows the clinical picture of the right heel pad after three days following initial debridement. Once complete, all wounds were left open and a wound VAC was applied. Three liters of sterile saline were then used to irrigate the wound. Gross wound contaminants were removed, including all devitalized bone. ![]() The initial operative encounter consisted of the patient being operated under spinal anesthesia. After imaging was completed and informed consent obtained, the patient underwent thorough wound debridement and NPWT was given. Wound wash was given with six liters of sterile saline at the bedside and the wound site dressed with moist gauze. The patient was stabilized with a below-knee splint and sent for radiographs. Preoperative radiographs are provided in Figure 2. It consisted of intravenous (IV) administration of augmentin 1.2 g, amikacin 500 mg, and metronidazole 100 ml. The abstract is scheduled to be published in the online supplement of the Tamilnadu Orthopaedic Association Journal.Ĭrush injury of the right heel pad exposing the underlying soft tissue and bone.Īt the emergency department, triple antibiotic prophylaxis was administered. The abstract of the case was accepted for paper presentation at the 53rd Annual Conference of Tamilnadu Orthopaedic Association (TNOACON) held from February 7 to 9, 2020, at Kingston Engineering College, Vellore, India. VAC can thus potentially replace microsurgical soft tissue transfer, reduce the risk of infection, and aid in salvaging the limb. So a single set of seven days of vacuum-assisted closure (VAC) was tried for this patient after secondary debridement, which, in turn, turned out to be a game-changer for the patient with extensive soft tissue loss in the foot. Initial debridement with regular dressing was done, which was associated with poor outcome. We report a case of a crush injury to the right heel pad, which caused an open comminuted fracture of the right calcaneum with bone loss. NPWT aids in forming granulation tissue, which serves as a wound bed for the skin graft and reduces the volume of soft tissue defects . Negative pressure wound therapy (NPWT), also known as topical negative pressure therapy, has revolutionized the world of wound care. The authors noted that the benefits significantly outweigh the costs of the VAC system, making it an essential treatment option for patients similar to the one presented in this case report. Once sealed, suction was set at the continuous pressure of -125 mm Hg. Negative pressure sponge dressing was then applied in this region and adhesive drapes were sealed. A total of seven days of NPWT was allowed. The patient in the current case report presented with an alleged history of a road traffic accident, sustaining a crush injury to his right heel pad, resulting in an open comminuted fracture of the right calcaneum with bone loss. The application of uniform negative pressure, which is delivered by vacuum-assisted closure (VAC) therapy, induces a physical response (macrostrain) and a biological response (microstrain). Negative pressure wound therapy (NPWT) can create the healing granulation tissue that will form a wound bed for the skin graft, thereby reducing the volume of the soft tissue defect. ![]()
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