Case report on effective use of Vacuum Assisted Wound Closure (VAC) system on a diabetic foot (heal ulcer)

Mr Upul Pathmasena1
1National Hospital- Sri Lanka, Colombo, Sri Lanka

Background: Heal ulcers are very complex, difficult to treat and it’s a great challenge to wound care practitioners. Delaying of wound healing is a significant burden to the patient, family, society and health care system especially in developing countries. Principle of therapy for heal ulcers is relief of pressure by off-loading, establishment of dermal micro circulation, correction of metabolic abnormalities, vigorous treatment of infections, good wound care with the treatments of the comorbidities and patient education. Even though the wound healing is slow, with provision of warm moist environment, wound healing could be accelerated. Vacuum Assisted Closure Systems have been shown to improve wound healing rates resulting in fewer amputations.

Case Report: This case report is on a successful treatment with Vacuum Assisted Wound Closure system on a poorly healing long standing diabetic fool ulcer of a 65-year old female patient. Initially the local hospital where she was treated had decided that she needs a below knee amputation as the calcaneum was exposed. At the time of presentation wound was two months old and there was evidence of active soft tissue infection.

A tissue debridement followed by application of a VAC dressing was used initially. After two rounds of VAC dressings lasting one week each, the wound condition improved significantly with good granulation formation. Subsequently the wound was managed with iodine and foam dressings which resulted in complete healing of the wound with fibrosis. Currently, 8 months after complete healing of the wound the patient remains fully ambulant.

Conclusion:   Vacuum Assisted Wound Closure Systems exhibits better wound healing rates, thus appeared to be a good alternative to conventional wound therapy in situations which otherwise would require an amputation.


Biography:

Born on August 1, 1967 in Colombo, Sri Lanka.

Entered School of Nursing Colombo in 1991. After successful completion of Nursing Education for 3 years, got appointed to the National Mental Health Institute Colombo.

Got certified in Enterostomal therapy from National Cancer Center South Korea in 2010 (WOCN)

Once completed the above, appointed as the WOCN in National Hospital Colombo and since then managing Stoma Care patients and conduct educational programs/workshops for medical students, student nurses etc.  Have attended World Union Wound Healing Society Conference 2016, Florence Italy and World Council of Entero Therapy Congress 2018 ( Kuala Lumpur, Malaysia)