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State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings.
J Vasc Surg 2006; 44(5):1029-37; discussion 1038JV

Abstract

BACKGROUND

Current treatment modalities for chronic leg ulcers are time consuming, expensive, and only moderately successful. Recent data suggest that creating a subatmospheric pressure by vacuum-assisted closure (V.A.C., KCI Concepts, San Antonio, Texas) therapy supports the wound healing process.

METHODS

The efficacy of vacuum-assisted closure in the treatment of chronic leg ulcers was prospectively studied in a randomized controlled trial in which 60 hospitalized patients with chronic leg ulcers were randomly assigned to either treatment by V.A.C. or therapy with conventional wound care techniques. The primary outcome measure was the time to complete healing (days). Statistical analysis was performed on the intention-to-treat basis.

RESULTS

The median time to complete healing was 29 days (95% confidence interval [CI], 25.5 to 32.5) in the V.A.C. group compared with 45 days (95% CI, 36.2 to 53.8) in the control group (P = .0001). Further, wound bed preparation during V.A.C. therapy was also significantly shorter at 7 days (95% CI 5.7 to 8.3) than during conventional wound care at 17 days (95% CI, 10 to 24, P = .005). The costs of conventional wound care were higher than those of V.A.C. Both groups showed a significant increase in quality of life at the end of therapy and a significant decrease in pain scores at the end of follow-up.

CONCLUSIONS

V.A.C. therapy should be considered as the treatment of choice for chronic leg ulcers owing to its significant advantages in the time to complete healing and wound bed preparation time compared with conventional wound care. Particularly during the preparation stage, V.A.C. therapy appears to be superior to conventional wound care techniques.

Authors+Show Affiliations

Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands. info@DermaClinic.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17000077

Citation

Vuerstaek, Jeroen D D., et al. "State-of-the-art Treatment of Chronic Leg Ulcers: a Randomized Controlled Trial Comparing Vacuum-assisted Closure (V.A.C.) With Modern Wound Dressings." Journal of Vascular Surgery, vol. 44, no. 5, 2006, pp. 1029-37; discussion 1038.
Vuerstaek JD, Vainas T, Wuite J, et al. State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. J Vasc Surg. 2006;44(5):1029-37; discussion 1038.
Vuerstaek, J. D., Vainas, T., Wuite, J., Nelemans, P., Neumann, M. H., & Veraart, J. C. (2006). State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. Journal of Vascular Surgery, 44(5), pp. 1029-37; discussion 1038.
Vuerstaek JD, et al. State-of-the-art Treatment of Chronic Leg Ulcers: a Randomized Controlled Trial Comparing Vacuum-assisted Closure (V.A.C.) With Modern Wound Dressings. J Vasc Surg. 2006;44(5):1029-37; discussion 1038. PubMed PMID: 17000077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - State-of-the-art treatment of chronic leg ulcers: A randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings. AU - Vuerstaek,Jeroen D D, AU - Vainas,Tryfon, AU - Wuite,Jan, AU - Nelemans,Patty, AU - Neumann,Martino H A, AU - Veraart,Joep C J M, Y1 - 2006/09/26/ PY - 2006/03/08/received PY - 2006/07/17/accepted PY - 2006/9/27/pubmed PY - 2006/12/9/medline PY - 2006/9/27/entrez SP - 1029-37; discussion 1038 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 44 IS - 5 N2 - BACKGROUND: Current treatment modalities for chronic leg ulcers are time consuming, expensive, and only moderately successful. Recent data suggest that creating a subatmospheric pressure by vacuum-assisted closure (V.A.C., KCI Concepts, San Antonio, Texas) therapy supports the wound healing process. METHODS: The efficacy of vacuum-assisted closure in the treatment of chronic leg ulcers was prospectively studied in a randomized controlled trial in which 60 hospitalized patients with chronic leg ulcers were randomly assigned to either treatment by V.A.C. or therapy with conventional wound care techniques. The primary outcome measure was the time to complete healing (days). Statistical analysis was performed on the intention-to-treat basis. RESULTS: The median time to complete healing was 29 days (95% confidence interval [CI], 25.5 to 32.5) in the V.A.C. group compared with 45 days (95% CI, 36.2 to 53.8) in the control group (P = .0001). Further, wound bed preparation during V.A.C. therapy was also significantly shorter at 7 days (95% CI 5.7 to 8.3) than during conventional wound care at 17 days (95% CI, 10 to 24, P = .005). The costs of conventional wound care were higher than those of V.A.C. Both groups showed a significant increase in quality of life at the end of therapy and a significant decrease in pain scores at the end of follow-up. CONCLUSIONS: V.A.C. therapy should be considered as the treatment of choice for chronic leg ulcers owing to its significant advantages in the time to complete healing and wound bed preparation time compared with conventional wound care. Particularly during the preparation stage, V.A.C. therapy appears to be superior to conventional wound care techniques. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/17000077/State_of_the_art_treatment_of_chronic_leg_ulcers:_A_randomized_controlled_trial_comparing_vacuum_assisted_closure__V_A_C___with_modern_wound_dressings_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(06)01303-6 DB - PRIME DP - Unbound Medicine ER -