VAC Therapy

V.A.C. Therapy is a topical treatment intended to promote healing in acute and chronic wounds. It involves the application of negative (sub atmospheric) pressure (Negative Pressure Wound Therapy) to the wound bed applied by a tube which decompresses a foam dressing, continuously or intermittently, depending on the type of wound being treated and the clinical objectives. Intermittent removal of used instillation fluid supports the cleaning and drainage of the wound bed and the removal of infectious material.

Mechanisms
V.A.C. Therapy consists of a foam dressing, which adapts to the contours of deep and irregularly shaped wounds. A drainage tube is placed in the dressing and an occlusive transparent film seals the wound and the drainage tube. The tube is connected to a vacuum source, which supplies the negative pressure. The concept is to turn an open wound into a controlled, closed wound while removing excess fluid from the wound bed, thus enhancing circulation and disposal of cellular waste from the lymphatic system.

KCI
In 1995 the Food and Drug Administration was presented with and first approved negative pressure equipment that was subsequently marketed as the VAC, by KCI (Kinetic Concepts, Inc).

Wounds
The technique is usually considered for chronic wounds (those that fail to progress through the normal phases of healing-inflammation, proliferation, maturation-and thus do not heal), acute wounds (wounds that are expected to heal and demonstrate evidence of progression through the phases of healing), and difficult wounds (wounds with such associated factors as diabetes, arterial insufficiency, and venous insufficiency). However, KCI claim that the VAC can be used for a variety of wounds, also those that are not as severe.

Diabetic Foot Wounds
In December 2007, a large multicenter randomized controlled trial was published. This trial shows a greater proportion of foot ulcers achieved complete ulcer closure with NPWT (73/169, 43.2%) than Advanced Moist Wound Therapy (48/166, 28.9%) within the 112-day Active Treatment Phase. The study also showed significantly faster wound healing, a reduced number of secondary amputations and no changes in therapy associated complications.

Products

 * VAC ATS was designed for higher acuity wounds for patients in acute care and long-term care facilities.
 * VAC Freedom is a portable VAC unit, designed for the homecare setting.
 * VAC Instill combines VAC Therapy with the automated delivery of topical wound solutions (medicine) to wound sites.

In 2007, KCI launched the next generation VAC products:


 * ActiVAC, a light weight unit for use in the homecare setting, lighter and smaller than VAC Freedom.
 * InfoVAC, for the acute care environment, offering access to wound progress data.

Advantages

 * Provides a closed moist wound healing environment
 * Decreases wound volume
 * Removes excess fluids that can inhibit wound healing
 * Helps remove interstitial fluid
 * Promotes granulation
 * Helps to decrease bacterial colonization at the wound site

Appropriate applications for VAC Therapy

 * Acute wounds
 * Partial thickness burns
 * Venous or arterial insufficiency ulcer unresponsive to standard therapy
 * Traumatic wounds (i.e., flap or meshed graft)
 * Pressure ulcers
 * Diabetic ulcers
 * Chronic open wounds
 * Acute and traumatic wounds
 * Flaps and grafts
 * Dehisced wounds